After reading this article, mothers are no longer afraid of mycoplasma pneumonia

Author: Niu Chao, Associate Researcher, Children's Hospital Affiliated to Chongqing Medical University

Reviewer: Luo Jian, deputy chief physician, Children's Hospital Affiliated to Chongqing Medical University

Mycoplasma pneumoniae is a microorganism smaller than bacteria and is the culprit of mycoplasma pneumonia. After many children are infected with mycoplasma pneumoniae, they mainly show symptoms of fever and cough, which causes anxiety among parents. Parents often take their children to the hospital to queue up in the middle of the night, and are often exhausted physically and mentally. In response to the related questions that parents often ask, we answer them one by one, hoping to reduce the psychological burden of family members with mycoplasma pneumoniae.

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1. Where does Mycoplasma pneumoniae come from? How to avoid infection?

Mycoplasma pneumoniae infection can occur throughout the year, with winter being the most common in northern my country and summer and autumn being the most common in southern China. Mycoplasma pneumoniae mainly comes from infected people, and its main modes of transmission among people are droplet transmission (such as coughing and sneezing) and close contact (such as kissing).

There is currently no vaccine for Mycoplasma pneumoniae. The main measures to prevent Mycoplasma pneumoniae are to avoid crowds, open windows for ventilation, wear masks and wash hands frequently; avoid parents taking care of their children while sick, and do not kiss their babies casually; pay attention to balanced nutrition and a healthy schedule.

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2. If I am infected with Mycoplasma pneumoniae, will I definitely get pneumonia?

Being infected with Mycoplasma pneumoniae does not mean that pneumonia will occur. Most children have no obvious symptoms or show mild cold symptoms, such as dry cough, sneezing, headache, transient fever, etc. Most children can recover naturally without treatment.

Mycoplasma pneumonia is more common in children aged 5 years and above, but can also occur in children under 5 years old. Children may experience repeated fever, severe cough, labored breathing, mental depression, etc. The symptoms of pneumonia in infants are often atypical, and may be manifested by frequent vomiting, choking, and spitting.

3. If Mycoplasma pneumoniae infection is suspected, what tests are generally required?

For children with fever and a slightly longer course of illness, suspected of being infected with Mycoplasma pneumoniae, their blood analysis results may be normal. Therefore, a normal blood analysis cannot completely rule out Mycoplasma infection. Sputum etiology testing and blood antibody testing are effective means of detecting Mycoplasma pneumoniae infection.

For children suspected of having Mycoplasma pneumonia, it is recommended that they go to a regular hospital for a complete chest X-ray or chest CT scan, as well as Mycoplasma pathogen examination, so as to promptly diagnose the child's condition and facilitate doctors to formulate treatment plans.

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4. What treatments are needed for infection with Mycoplasma pneumoniae?

Mycoplasma pneumoniae infection is self-limiting to a certain extent, and most children with the disease can recover without treatment. If the symptoms are not severe, oral antipyretic, antitussive, expectorant and other drugs can be used, and nebulization can be used to relieve the child's discomfort.

If mycoplasma pneumonia is suspected, the cause should be identified as soon as possible. Early use of macrolide drugs such as azithromycin, clarithromycin, erythromycin and roxithromycin can relieve children's discomfort and shorten the duration of illness.

Parents should note that penicillins (such as amoxicillin, flucloxacillin, etc.) or cephalosporins (such as cefaclor, cefixime, etc.) are ineffective against Mycoplasma pneumoniae.

5. When using azithromycin, children often suffer from diarrhea and stomach pain. What is going on?

Azithromycin is one of the most commonly used antibiotics for treating mycoplasma infection in children and is safe for most children. The most common adverse reactions to azithromycin in children are abdominal pain, diarrhea, decreased appetite and other digestive symptoms, which can gradually recover after stopping the drug, so parents do not need to be overly nervous. If azithromycin is used for infusion, reducing the infusion rate can alleviate children's digestive symptoms.

6. In what cases is Mycoplasma pneumonia considered to be aggravated?

The following situations indicate that mycoplasma pneumonia has worsened. Parents should take their children to see a doctor in time: ① Repeated fever for 5 to 7 days; ② Pale or cyanotic complexion, wheezing, shortness of breath, and difficulty breathing; ③ Poor spirit and appetite; ④ No improvement after 5 to 7 days of azithromycin treatment. Mycoplasma pneumonia should be treated in time when it worsens. Children who continue to have fever and no improvement after more than 14 days of onset may have sequelae.

7. What should I do if atelectasis or consolidation occurs in the lungs?

Mycoplasma pneumonia may cause atelectasis and consolidation, which are generally caused by severe inflammation and mucus blocking the airways. If there is no improvement after follow-up examination after treatment, it is recommended to be hospitalized for bronchoscopy as soon as possible to reduce the occurrence of complications and sequelae.

References

【1】National Health Commission. Guidelines for the diagnosis and treatment of Mycoplasma pneumonia in children (2023 edition).