Comparative analysis of the clinical characteristics of severe Mycoplasma pneumoniae pneumonia and severe bacterial pneumonia in children

Abstract

Purpose: The aim of this study was to analyze the clinical characteristics of severe Mycoplasma pneumoniae pneumonia and severe bacterial pneumonia in children to provide a basis for clinical recognition and diagnosis. Methods: This was a retrospective analysis of 130 cases of severe Mycoplasma pneumoniae pneumonia (SMPP), 81 cases of severe Streptococcus pneumoniae pneumonia (SPP) and 105 cases of severe Haemophilus influenzae pneumonia (SHIP) in children. Demographic, clinical, laboratory, and imaging data were compared between groups. One-way analysis of variance or Kruskal-Wallis test was used for continuous variables, chi-square test was used for categorical variables, and rank-sum test was used for ranked data. The level of statistical significance was set at P < 0.05. Results: All groups showed male predominance (P < 0.05). The SMPP group had older patients, longer hospital stays, prolonged fever, and higher interleukin-6, lactate dehydrogenase, and D-dimer levels (P < 0.05). Imaging revealed a higher proportion of unilateral solid lung lesions in SMPP, with increased tracheal stenosis, emphysema, pleural effusion, and pulmonary embolism (P < 0.05). Fiberoptic bronchoscopy detected more sputum plugs in SMPP (P < 0.05). Conversely, SPP and SHIP groups had younger patients, more wet rales/wheezing, higher white blood cell counts and neutrophil ratios, and bilateral patchy lung shadows (P < 0.05). Conclusion: Differences in age of onset, laboratory tests, like IL-6, and imaging manifestations between SMPP and severe bacterial pneumonia can help us to recognize them early and thus target treatment more appropriately.