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Early Additional Immune-Modulators for Mycoplasma pneumoniae Pneumonia in Children: An Observation Study.

Youn YS, Lee SC, Rhim JW, Shin MS, Kang JH, Lee KY - Infect Chemother (2014)

Bottom Line: The majority of the patients who received corticosteroids (86/90 cases) showed rapid defervescence within 48 hours with improved clinical symptoms, regardless of the used antibiotics.Also, 4 patients who received additional IVIG improved both clinically and radiographically within 2 days without adverse reaction.In the era of macrolide-resistant MP strains, early additional immune-modulator therapy with antibiotics might prevent from the disease progression and reduce the disease morbidity without adverse reaction.

View Article: PubMed Central - PubMed

Affiliation: Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, Korea. ; Department of Pediatrics, College of Medicine, The Catholic University of Korea, Daejeon St. Mary's Hospital, Daejeon, Korea.

ABSTRACT

Background: Mycoplasma pneumoniae (MP) pneumonia is a self-limiting disease, but some patients complain of progressive pneumonia, despite of appropriate antibiotic treatment. We aimed to introduce the role of immune-modulators (corticosteroid and/or intravenous immunoglobulin, IVIG) treatment for childhood MP pneumonia based on previous our experiences.

Materials and methods: A retrospective case series analysis for 183 children with MP pneumonia was performed. MP pneumonia patients were diagnosed by two Immunoglobulin M (IgM) tests: the micro-particle agglutination method (≥1:40) and the cold agglutination test (≥1:4), and were examined twice at the initial admission and at discharge. Among 183 MP pneumonia patients, 90 patients with persistent fever for over 48 hours after admission or those with severe respiratory symptoms and signs received additional prednisolone (82 patients, 1 mg/kg/day) or intravenous methylprednisolone (8 patients, 5-10 mg/kg/day) with antibiotics. Four patients with aggravated clinical symptoms and chest radiographic findings after corticosteroid treatment received IVIG (1 g/kg/day, 1-2 doses).

Results: Mean age of 183 patients was 5.5 ± 3.2 years (6 months-15 years), and the male: female ratio was 1.1:1 (96:87). Fifty-seven patients (31%) were seroconverters and 126 seropositive patients showed increased diagnostic IgM antibody titres during admission (over 4 folds). The majority of the patients who received corticosteroids (86/90 cases) showed rapid defervescence within 48 hours with improved clinical symptoms, regardless of the used antibiotics. Also, 4 patients who received additional IVIG improved both clinically and radiographically within 2 days without adverse reaction.

Conclusions: In the era of macrolide-resistant MP strains, early additional immune-modulator therapy with antibiotics might prevent from the disease progression and reduce the disease morbidity without adverse reaction.

No MeSH data available.


Related in: MedlinePlus

Monthly cases of Mycoplasma pneumoniae pneumonia patients.
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Figure 2: Monthly cases of Mycoplasma pneumoniae pneumonia patients.

Mentions: The mean age of 183 MP patients was 5.5 ± 3.2 years (ranged from 6 months to 15 years), and the male-to-female ratio was 1.1:1 (96:87). The age distribution of the subjects is shown in Figure 1, and the peak of cases was observed in summer and autumn season in Figure 2. In pneumonia patterns, 68 patients showed the bronchopneumonia, and 115 patients showed the segmental/lobar pneumonia according to our classification criteria [10]. Fifty-seven patients (31%) were seroconverters (from negative to positive cut-off values) and 126 seropositive patients showed increased diagnostic IgM antibody titres during admission. Polymerase chain reaction (PCR) assay for viral antigens of 16 respiratory viruses was checked in 79 patients; 7 patients were positive viral antigens (3 rhinovirus, 2 respiratory syncitial virus (RSV), 1 influenza B, and 1 rhinovirus and RSV).


Early Additional Immune-Modulators for Mycoplasma pneumoniae Pneumonia in Children: An Observation Study.

Youn YS, Lee SC, Rhim JW, Shin MS, Kang JH, Lee KY - Infect Chemother (2014)

Monthly cases of Mycoplasma pneumoniae pneumonia patients.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4285006&req=5

Figure 2: Monthly cases of Mycoplasma pneumoniae pneumonia patients.
Mentions: The mean age of 183 MP patients was 5.5 ± 3.2 years (ranged from 6 months to 15 years), and the male-to-female ratio was 1.1:1 (96:87). The age distribution of the subjects is shown in Figure 1, and the peak of cases was observed in summer and autumn season in Figure 2. In pneumonia patterns, 68 patients showed the bronchopneumonia, and 115 patients showed the segmental/lobar pneumonia according to our classification criteria [10]. Fifty-seven patients (31%) were seroconverters (from negative to positive cut-off values) and 126 seropositive patients showed increased diagnostic IgM antibody titres during admission. Polymerase chain reaction (PCR) assay for viral antigens of 16 respiratory viruses was checked in 79 patients; 7 patients were positive viral antigens (3 rhinovirus, 2 respiratory syncitial virus (RSV), 1 influenza B, and 1 rhinovirus and RSV).

Bottom Line: The majority of the patients who received corticosteroids (86/90 cases) showed rapid defervescence within 48 hours with improved clinical symptoms, regardless of the used antibiotics.Also, 4 patients who received additional IVIG improved both clinically and radiographically within 2 days without adverse reaction.In the era of macrolide-resistant MP strains, early additional immune-modulator therapy with antibiotics might prevent from the disease progression and reduce the disease morbidity without adverse reaction.

View Article: PubMed Central - PubMed

Affiliation: Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, Korea. ; Department of Pediatrics, College of Medicine, The Catholic University of Korea, Daejeon St. Mary's Hospital, Daejeon, Korea.

ABSTRACT

Background: Mycoplasma pneumoniae (MP) pneumonia is a self-limiting disease, but some patients complain of progressive pneumonia, despite of appropriate antibiotic treatment. We aimed to introduce the role of immune-modulators (corticosteroid and/or intravenous immunoglobulin, IVIG) treatment for childhood MP pneumonia based on previous our experiences.

Materials and methods: A retrospective case series analysis for 183 children with MP pneumonia was performed. MP pneumonia patients were diagnosed by two Immunoglobulin M (IgM) tests: the micro-particle agglutination method (≥1:40) and the cold agglutination test (≥1:4), and were examined twice at the initial admission and at discharge. Among 183 MP pneumonia patients, 90 patients with persistent fever for over 48 hours after admission or those with severe respiratory symptoms and signs received additional prednisolone (82 patients, 1 mg/kg/day) or intravenous methylprednisolone (8 patients, 5-10 mg/kg/day) with antibiotics. Four patients with aggravated clinical symptoms and chest radiographic findings after corticosteroid treatment received IVIG (1 g/kg/day, 1-2 doses).

Results: Mean age of 183 patients was 5.5 ± 3.2 years (6 months-15 years), and the male: female ratio was 1.1:1 (96:87). Fifty-seven patients (31%) were seroconverters and 126 seropositive patients showed increased diagnostic IgM antibody titres during admission (over 4 folds). The majority of the patients who received corticosteroids (86/90 cases) showed rapid defervescence within 48 hours with improved clinical symptoms, regardless of the used antibiotics. Also, 4 patients who received additional IVIG improved both clinically and radiographically within 2 days without adverse reaction.

Conclusions: In the era of macrolide-resistant MP strains, early additional immune-modulator therapy with antibiotics might prevent from the disease progression and reduce the disease morbidity without adverse reaction.

No MeSH data available.


Related in: MedlinePlus