Five questions and answers about Mycoplasma pneumoniae infection in children

Recently, Mycoplasma pneumoniae has become prevalent in some areas, and some hospitals have seen an increase in cases of Mycoplasma pneumoniae infection in children. What is Mycoplasma pneumoniae infection? What symptoms should we be alert to? How to prevent and treat it? In response to social concerns, the reporter interviewed experts such as Xu Baoping, director of the Respiratory Department of Beijing Children's Hospital Affiliated to Capital Medical University, Zhao Shunying, director of the Second Respiratory Department of Beijing Children's Hospital Affiliated to Capital Medical University, and Zhang Haidi, a pediatrician at the First Affiliated Hospital of Guangzhou Medical University, for interpretation.

Q: What is Mycoplasma pneumoniae infection?

A: Mycoplasma pneumoniae is a pathogenic microorganism with a size between bacteria and viruses, with a diameter of 2 to 5 microns. It is a prokaryotic pathogenic microorganism and lacks a cell wall. Mycoplasma pneumoniae is mainly transmitted through droplets and direct contact, with an incubation period of 1 to 3 weeks.

Mycoplasma pneumoniae infection is common in any season. It is prevalent in autumn and winter in the north and in summer and autumn in the south. It occurs periodically every 3 to 7 years and can last up to 1 year. Mycoplasma pneumoniae infection is a common respiratory infection in children in my country. It is more common in children aged 5 years and above, but children under 5 years old can also get sick.

Q: What are the symptoms of Mycoplasma pneumoniae infection? Which symptoms should we be alert to?

Answer: The clinical manifestations of children infected with Mycoplasma pneumoniae vary greatly: mild cases may not develop the disease, or only show upper respiratory tract infection; severe cases can cause pneumonia, pulmonary consolidation, pleural effusion, etc.

The main clinical manifestations of this disease are fever and cough, which may be accompanied by headache, runny nose, sore throat, earache, etc. Continuous high fever indicates that the condition may be serious. Some children have wheezing, which is more common in infants and young children.

If parents find that their children have severe coughs and high fevers, they should take them to the doctor as soon as possible. If the child has symptoms of suffocation and shortness of breath, parents can pat their backs hard to clear the airway and then go to the hospital as soon as possible.

Q: The symptoms of Mycoplasma pneumoniae infection are easily confused with diseases such as influenza. How can we distinguish them?

A: There are many ways to diagnose Mycoplasma pneumoniae infection, such as serum antibody testing, nucleic acid testing, etc. Whether it is Mycoplasma pneumonia requires doctors to make a comprehensive judgment based on the child's medical history, symptoms and signs, combined with relevant routine laboratory tests.

In addition to combining clinical and imaging manifestations as well as etiology and serology tests to make judgments, parents can also observe the child's cough. Mycoplasma pneumoniae infection generally causes paroxysmal and clustered coughs, which are dry coughs in the early stages and are more severe, even affecting eating and sleeping.

Question: How to prevent and control it?

A: Mycoplasma pneumoniae is inherently resistant to antibiotics that act on the cell wall (such as penicillins and cephalosporins). Currently, the first-line treatment is mainly macrolide antibiotics, and commonly used drugs include azithromycin, erythromycin, clarithromycin, etc. Children who are resistant to macrolide antibiotics may need to use other antibiotics.

Antibiotics are prescription drugs and must be used under the guidance of a doctor. Children with refractory mycoplasma infection and severe mycoplasma infection require comprehensive treatment, such as glucocorticoids and bronchoscopic interventional therapy. In February this year, the National Health Commission issued the "Guidelines for the Diagnosis and Treatment of Mycoplasma Pneumonia in Children (2023 Edition)" to further improve the standardization of diagnosis and treatment. The key is timely identification and timely medical treatment. The best treatment window is within 5 to 10 days after fever.

To prevent Mycoplasma pneumoniae infection, we should develop good personal hygiene habits, such as maintaining social distance, hand hygiene, frequent ventilation, etc., and wear masks when necessary. In autumn and winter, we should also pay attention to keeping warm while ventilating indoors.

Q: Will Mycoplasma pneumonia cause “white lung”?

A: This type of pneumonia may cause mucus plugs to block the bronchi, which in turn causes "atelectasis", that is, a decrease in the air volume of the lungs, resulting in "white lung" on imaging. However, this is different from the "white lung" of diffuse lesions in both lungs.

Through back patting, expectoration, bronchoscopy and other methods, children can be cured in a relatively short period of time, and their lives are basically not in danger. Most children with Mycoplasma pneumoniae infection have a good prognosis, while children with severe and refractory Mycoplasma pneumoniae infection may have residual lung structure or function damage and require long-term follow-up.