Infección por Mycoplasma pneumoniae en niños hospitalizados por neumonía
Abstract
Objetivo: describir las características clínicas, epidemiológicas, radiográficas, de laboratorio y evolutivas de casos de neumonía atípica por Mycoplasma pneumoniae. Material y métodos: serie de casos consecutivos que incluyó pacientes con edades entre 2 meses y 14 año internados en las unidades de Infectología y Neumología del Hospital del Niño "Dr. Ovidio Aliaga Uría" durante el año 2007 con el diagnóstico de neumonía atípica. Resultados: del total de internaciones por neumonía, 8.6% correspondieron a neumonías atípicas. Veintinueve pacientes fueron incluidos en el análisis. La determinación de IgM anti-Mycoplasma pneumoniae se realizó en 15 pacientes (51.7%).La edad de presentación fue más frecuente en el grupo entre 1 y 4 años (media: 3 años). Se observó un predominio masculino. Se registraron más casos en Otoño (53.3%). El promedio de días de enfermedad fue de 6 días. Las manifestaciones clínicas más comunes fueron tos (97%), fiebre (90%) y decaimiento general (79%). Estertores crepitantes (65.5%) y sibilancias (44.8%) fueron los hallazgos auscultatorios más frecuentes. El recuento de leucocitos promedio fue de 10,014 ± 1 867/mm3. El valor relativo de neutrófilos fue 55.5%. El patrón intersticial fue predominante en los estudios radiográficos (60%). El uso de betalactámicos como tratamiento empírico inicial fue común (60%) y condicionó mayor permanencia hospitalaria (7.7±3.8 vs. 5.1±1.9 días; p < 0.05). Conclusiones: la neumonía por Mycoplasma pneumoniae no presenta ningún síntoma, signo o patrón radiológico que enfoque claramente la etiología; sin embargo, por su frecuencia, debe ser el primer diagnóstico de sospecha en presencia del perfil clínico, epidemiológico, radiográfico y de laboratorio descrito en esta serie de casos
Objective: to describe clinical, epidemiological, radiographic, laboratory and, progress characteristics of Mycoplasma pneumoniae infection in hospitalized patients with pneumonia. Methods: consecutive case series that included patients who had ages between 2 mo old and 14 yr old admitted to Infectology and Pulmonology Units at Children's Hospital Dr. Ovidio Aliaga Uría with diagnosis of atypical pneumonia during 2007. Results: of 368 admissions for pneumonia, 8.6% compatible with atypical pneumonia. Twenty-nine patients were included for analysis (n=29). IgM serology for Mycoplasma pneumoniae infection was completed in 15 patients (51.7%). Pneumonia was more frequent in infants and pre-school children (average: 3 years). Masculine predominance was observed. Most cases were registered in autumn (53.3%). The average of illness days was six. The most common clinical features were cough (97%), fever (90%) and, malaise (79%). Crackles (65.5%) and wheezing (44.8%) were frequent physical findings. Leukocyte count was in average 10 014 ± 1 867/mm3. The relative value of neutrophils was 55.5%. Interstitial pattern was predominant in radiographic films (60%). The betalactam use as initial empiric therapy was common (60%) and associated with longer length of hospital stay (7.7±3.8d vs. 5.1± 1.9d; p < 0.05). Conclusions: pneumonia in patients who have Mycoplasma pneumoniae infection does not have any symptom, sign or radiological pattern that focuses clearly the etiology; however, considering its emerging role, it should be the first diagnosis of suspicion in presence of the clinical, epidemiological, radiological and, laboratory profile described in this case review
Objective: to describe clinical, epidemiological, radiographic, laboratory and, progress characteristics of Mycoplasma pneumoniae infection in hospitalized patients with pneumonia. Methods: consecutive case series that included patients who had ages between 2 mo old and 14 yr old admitted to Infectology and Pulmonology Units at Children's Hospital Dr. Ovidio Aliaga Uría with diagnosis of atypical pneumonia during 2007. Results: of 368 admissions for pneumonia, 8.6% compatible with atypical pneumonia. Twenty-nine patients were included for analysis (n=29). IgM serology for Mycoplasma pneumoniae infection was completed in 15 patients (51.7%). Pneumonia was more frequent in infants and pre-school children (average: 3 years). Masculine predominance was observed. Most cases were registered in autumn (53.3%). The average of illness days was six. The most common clinical features were cough (97%), fever (90%) and, malaise (79%). Crackles (65.5%) and wheezing (44.8%) were frequent physical findings. Leukocyte count was in average 10 014 ± 1 867/mm3. The relative value of neutrophils was 55.5%. Interstitial pattern was predominant in radiographic films (60%). The betalactam use as initial empiric therapy was common (60%) and associated with longer length of hospital stay (7.7±3.8d vs. 5.1± 1.9d; p < 0.05). Conclusions: pneumonia in patients who have Mycoplasma pneumoniae infection does not have any symptom, sign or radiological pattern that focuses clearly the etiology; however, considering its emerging role, it should be the first diagnosis of suspicion in presence of the clinical, epidemiological, radiological and, laboratory profile described in this case review
Description
Vol. 46, No. 3