Mycoplasma pneumonia is coming in full force, how should parents respond?

Author: Xia Yanbin, Chief Physician of Pediatrics, Beijing Electric Power Hospital

Reviewer: Lu Nianfang, Chief Physician, Department of Critical Care Medicine, Beijing Electric Power Hospital

As the name suggests, Mycoplasma pneumonia is a common disease caused by Mycoplasma pneumoniae, which is neither a bacterium nor a virus, but a microorganism in between. The disease is the most common community-acquired pneumonia in children aged 5 years and above in my country, but children under 5 years old can also develop the disease, which can affect the bronchi, bronchioles, alveoli and lung interstitium. Typical symptoms are mainly fever and cough, which may also be accompanied by headache, runny nose, sore throat, earache, etc. The fever is mainly moderate to high fever, the cough is more severe, and some infants and young children have wheezing. Most lung signs are not obvious in the early stages, so it has the characteristics of "severe symptoms and mild signs".

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Recently, mycoplasma pneumonia has been spreading aggressively. We often encounter anxious parents and haggard children in the outpatient clinic. After taking their children to see a doctor, parents often ask anxiously: "Doctor, will my child have white lung?" "Doctor, my eldest child has mycoplasma pneumonia, is the second child also?" and so on. So, facing the "mycoplasma pneumonia" that has become a hot search, how should parents deal with it in the "big year" of mycoplasma pneumonia?

First of all , according to the characteristic course of Mycoplasma pneumonia, after infection with Mycoplasma pneumonia, it takes 5 to 7 days from the onset of symptoms (such as fever and cough) to the appearance of pneumonia on the chest X-ray (such as patchy shadows), and timely anti-mycoplasma treatment should also be given during this time period. As a parent, when your child has symptoms of fever and cough, don't panic, don't blindly use medication, and don't seek medical attention immediately. You should carefully observe changes in your child's condition. It is currently believed that Mycoplasma pneumonia can heal itself, and most of the time, symptoms such as fever will subside about 3 days after onset. If the child's symptoms do not improve after 3 days, or even worsen cough and persistent high fever, seek medical attention immediately.

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Secondly , in the early stage of Mycoplasma pneumonia, lung rales often do not appear. Therefore, it is not possible to judge whether pneumonia is present by auscultation of the lungs. Imaging examination is very important in diagnosis (most children with Mycoplasma pneumonia are found through imaging examination). Common chest imaging examination methods include chest X-ray or CT. In general, chest X-ray examination can detect the lesion. The radiation exposure dose of chest CT is about twice that of chest X-ray.

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Once again , if conditions permit, nucleic acid testing for Mycoplasma pneumoniae should be performed as soon as possible, using nasopharyngeal swabs or throat swabs to determine whether it is Mycoplasma infection. Because generally, positive antibodies appear later after infection with Mycoplasma pneumoniae, mostly 4 to 7 days after infection, but they exist in the body for a long time (up to several months to 1 year). Early negative antibody tests cannot rule out Mycoplasma pneumoniae infection. If the antibody is positive at the early stage of the disease, it may also be a previous infection with Mycoplasma pneumoniae.

In addition , because the phenomenon of Mycoplasma pneumoniae resistance to macrolide antibiotics is becoming increasingly common in China, many children with Mycoplasma pneumoniae pneumonia do not have the expected effect after receiving azithromycin treatment (symptoms are not controlled within the expected time after 2 days of medication), and some children may also progress to severe or even critical illness, with sequelae. Therefore, when doctors want to use drugs beyond the instructions for children, parents do not need to question the doctor too much, and it is best to follow the doctor's advice. In addition, current domestic and foreign research data believe that doxycycline will not affect the teeth for children over 8 years old because their enamel formation has been completed. For children under 8 years old, the use of doxycycline at a safe dose and short course (within 21 days) is unlikely to cause permanent tooth discoloration. When taking doxycycline orally, you need to take the medicine upright, not lying down. Drink water before taking the medicine, then take the medicine, and then drink a lot of water. To prevent photosensitivity reactions to doxycycline, avoid excessive sun exposure during medication.

Finally , because Mycoplasma pneumoniae can be easily transmitted through droplets or direct contact in crowded and poorly ventilated environments, parents should prevent Mycoplasma infection in daily life and do the following: keep the room ventilated, cover your mouth and nose when coughing or sneezing, maintain good hand hygiene, wash your hands frequently, avoid going to crowded public places, and wear a mask when you must go.

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