Case Series
Clinical Spectrum and Severity of Mycoplasma pneumoniae Infection in Children From a Rural Tertiary Centre: A Case Series
SR01-SR07
Correspondence
Smita Priyadashan Jategaonkar,
Professor, OPD No. 18, Department of Paediatrics, Mahatma Gandhi Institute of Medical Sciences, Sevagram, Wardha, Maharashtra, India.
E-mail: sjategaonkar13@gmail.com
Mycoplasma pneumoniae, a common cause of Community Acquired Pneumonia (CAP) in children is traditionally considered a mild illness. Increasing evidence suggests broader clinical spectrum with significant respiratory and extrapulmonary involvement. This case series consists of 20 hospitalised children with laboratory-confirmed M. pneumoniae infection at rural tertiary care centre. Diagnosis was confirmed using respiratory Real-time Polymerase Chain Reaction (RT-PCR) in all patients, with serology performed in four children, all of whom tested positive. The median age observed was six years (IQR 2.5-9 years) with 12 males and 8 females. Six children (30%) were aged between six months-five years, 10 (50%) were 6-10 years and four above 10 years. RT-PCR for Mycoplasma pneumoniae was positive in all patients (100%). Fever (19/20) and cough (20/20) were the most common presenting symptoms. Extrapulmonary manifestations included dermatological and haematological involvement in 3/20 children each, and musculoskeletal involvement in 1/20. Disease severity was mild in 7/20 children, moderate in 6/20, severe in 6/20, and critical in 1/20. Eighteen children received macrolide therapy, of whom 6/18 required escalation to doxycycline. Respiratory support was required in 13/20 children, including oxygen therapy (6/20), non-invasive ventilation (6/20), and mechanical ventilation (1/20). Inflammatory markers were elevated, with a median C-reactive Protein (CRP) of 29 mg/L (IQR 5-40), while low-to-normal leukocyte counts were commonly observed. Nineteen children recovered and were discharged, while one child died due to refractory shock and respiratory failure. In resource limited settings where access to rapid molecular diagnostics may be constrained, recognition of indirect clinical and laboratory clues may aid early suspicion and management.