Clinical features of severe mycoplasma pneumoniae pneumonia with pulmonary complications in childhood: a retrospective study.

Abstract Background Incidence of severe M. pneumoniae pneumonia (SMPP) reported in China was increasing in the last decade. We aimed to evaluate clinical features in pediatric SMPP with pulmonary complications according to laboratory test and chest radiographic resolution patterns.Methods We retrospectively reviewed 93 SMPP patients between January 2016 and December 2018, and they were grouped by pneumonia pattern: pulmonary complication group (63 patients) and extensive lung lesion without pulmonary complication group (30 patients).Results SMPP patients of pleural effusion and necrotizing pneumonia showed longer fever duration, high serum value of lactic dehydrogenase (LDH), D-dimer and LDH to albumin ratio (LAR). LAR and D-dimer were associated with moderate and massive pleural effusion,and D-dimer was associated with lung necrosis. The average time of radiographic resolution in pulmonary complication group was 12 weeks, and those with elevated D-dimer were significantly more likely to have longer time to radiographic clearance.Conclusions M. pneumoniae pneumonia patients with pleural effusion or lung necrosis were more severe than those without pulmonary complication, LAR and D-dimer might be used as parameters to identify susceptible children of pleural effusion or lung necrosis and longer time to radiographic clearance among patients with SMPP.