Clinical features of Mycoplasma pneumoniae pneumonia in children without fever

Abstract

Background: Mycoplasma pneumoniae (MP) is one of the most common causes of community-acquired pneumonia in children. Most children have fever. In 2021, we found that the proportion of children without fever increased. The aim of this study is to summarize the differences in the clinical characteristics of children with MP pneumonia who are febrile or not, and to raise awareness of children who are not febrile. Method: Demographic information of the children was collected on admission. Clinical manifestations during the course of the disease and the first laboratory, imaging, and pulmonary function tests before discharge were recorded and compared. Results: From August to December, a total of 542 people were included in the study. We found that older children were more likely to have fever. Inflammatory indicators including procalcitonin (P = 0.030), C-reaction protein (P < 0.001), erythrocyte sedimentation rate (P < 0.001), ferritin (P = 0.040) and the rate of atelectasis (P = 0.049) of febrile children were higher in febrile children. However, the elevated lactate dehydrogenase and pulmonary function impairment (P all > 0.05), especially the small airway function impairment, are no lower in afebrile children than in febrile children. Conclusion: The fever rate is lower in younger children, but wheezing is more common. In afebrile children, the impairment of organ and lung function was no less than in febrile children. Therefore, attention should also be paid to children who are not febrile.