Clinical Analysis and Risk Factors of Bronchiolitis Obliterans After Mycoplasma Pneumoniae Pneumonia

Overview

Journal Infect Drug Resist

Publisher Dove Medical Press

Date 2022 Aug 4

PMID 35924019

Authors

Hao-Qi Zheng

Yu-Cong Ma

Yu-Quan Chen

Yan-Yue Xu

Yan-Lin Pang

Li Liu

Affiliations

Soon will be listed here.

Abstract

Purpose: Severe mycoplasma pneumoniae (MP) pneumonia can cause bronchiolitis obliterans (BO). In order to improve the prognosis of BO, it is necessary to grasp the clinical characteristics and risk factors of BO after severe MP pneumonia and intervene as soon as possible.

Patients And Methods: This study retrospectively analyzed the clinical data of 110 patients with severe MP pneumonia, and divided them into BO group (22 cases) and non-BO group (88 cases). The clinical characteristics of BO group were analyzed, and the clinical data of two groups were compared to identify the risk factors of BO.

Results: At the time of diagnosis, all BO patients had symptoms of cough and wheezing, and 10 (45.45%) had decreased exercise intolerance. Lung function showed moderate to severe obstructive ventilatory dysfunction, high-resolution computed tomography (HRCT) showed mosaic perfusion patterns. Multivariate binomial regression analysis showed that higher levels of serum lactate dehydrogenase (LDH) and hypoxemia were independent risk factors for BO after severe MP pneumonia.

Conclusion: Higher levels of serum LDH and hypoxemia were independent risk factors for BO after severe MP pneumonia. For patients with risk factors, clinicians should regular follow-up for early diagnosis and intervention of BO.

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References

Shimizu T . Inflammation-inducing Factors of Mycoplasma pneumoniae. Front Microbiol. 2016; 7:414. PMC: 4814563. DOI: 10.3389/fmicb.2016.00414. View

Liu T, Lee W, Tsai C, Kuo K, Lee C, Hsieh K . Serum lactate dehydrogenase isoenzymes 4 plus 5 is a better biomarker than total lactate dehydrogenase for refractory Mycoplasma pneumoniae pneumonia in children. Pediatr Neonatol. 2018; 59(5):501-506. DOI: 10.1016/j.pedneo.2017.12.008. View

Inamura N, Miyashita N, Hasegawa S, Kato A, Fukuda Y, Saitoh A . Management of refractory Mycoplasma pneumoniae pneumonia: utility of measuring serum lactate dehydrogenase level. J Infect Chemother. 2014; 20(4):270-3. DOI: 10.1016/j.jiac.2014.01.001. View

Yu J . Postinfectious bronchiolitis obliterans in children: lessons from bronchiolitis obliterans after lung transplantation and hematopoietic stem cell transplantation. Korean J Pediatr. 2016; 58(12):459-65. PMC: 4705325. DOI: 10.3345/kjp.2015.58.12.459. View

Colom A, Teper A . Post-infectious bronchiolitis obliterans. Pediatr Pulmonol. 2018; 54(2):212-219. DOI: 10.1002/ppul.24221. View

Li Y, Cheng H, Wang H, Wang Y, Liu L . Composite factors, including mycoplasmal pneumonia, hypersensitivity syndrome, and medicine, leading to bronchiolitis obliterans in a school-age child. Clin Pediatr (Phila). 2014; 53(14):1409-12. DOI: 10.1177/0009922814541808. View

Chen J, Liu X, Du W, Srivastava R, Fu J, Zheng M . Pulmonary Function Testing in Pediatric Pneumonia Patients With Wheezing Younger Than 3 Years of Age. Glob Pediatr Health. 2019; 6:2333794X19840357. PMC: 6457021. DOI: 10.1177/2333794X19840357. View

Yu X, Ma Y, Gao Y, You H . Epidemiology of Adenovirus Pneumonia and Risk Factors for Bronchiolitis Obliterans in Children During an Outbreak in Jilin, China. Front Pediatr. 2021; 9:722885. PMC: 8506152. DOI: 10.3389/fped.2021.722885. View

Wang X, Liu C, Wang M, Zhang Y, Li H, Liu G . Clinical features of post-infectious bronchiolitis obliterans in children undergoing long-term azithromycin treatment. Exp Ther Med. 2015; 9(6):2379-2383. PMC: 4473509. DOI: 10.3892/etm.2015.2418. View

10.

Rodrigues E, Machado A, Silva S, Nunes B . Excess pneumonia and influenza hospitalizations associated with influenza epidemics in Portugal from season 1998/1999 to 2014/2015. Influenza Other Respir Viruses. 2018; 12(1):153-160. PMC: 5818339. DOI: 10.1111/irv.12501. View

11.

Murtagh P, Giubergia V, Viale D, Bauer G, Gonzalez Pena H . Lower respiratory infections by adenovirus in children. Clinical features and risk factors for bronchiolitis obliterans and mortality. Pediatr Pulmonol. 2009; 44(5):450-6. DOI: 10.1002/ppul.20984. View

12.

Rodriguez N, Mondeja B, Sardinas R, Vega D, Dumke R . First detection and characterization of macrolide-resistant Mycoplasma pneumoniae strains in Cuba. Int J Infect Dis. 2019; 80:115-117. DOI: 10.1016/j.ijid.2018.12.018. View

13.

Choi Y, Jeon J, Oh J . Critical combination of initial markers for predicting refractory Mycoplasma pneumoniae pneumonia in children: a case control study. Respir Res. 2019; 20(1):193. PMC: 6706904. DOI: 10.1186/s12931-019-1152-5. View

14.

Zhao C, Liu J, Yang H, Xiang L, Zhao S . Mycoplasma pneumoniae-Associated Bronchiolitis Obliterans Following Acute Bronchiolitis. Sci Rep. 2017; 7(1):8478. PMC: 5559585. DOI: 10.1038/s41598-017-08861-7. View

15.

. [Guidelines for management of community acquired pneumonia in children(the revised edition of 2013) (II)]. Zhonghua Er Ke Za Zhi. 2014; 51(11):856-62. View

16.

Lee E, Lee Y . Risk factors for the development of post-infectious bronchiolitis obliterans after Mycoplasma pneumoniae pneumonia in the era of increasing macrolide resistance. Respir Med. 2020; 175:106209. DOI: 10.1016/j.rmed.2020.106209. View

17.

Dai W, Wang H, Zhou Q, Li D, Feng X, Yang Z . An integrated respiratory microbial gene catalogue to better understand the microbial aetiology of Mycoplasma pneumoniae pneumonia. Gigascience. 2019; 8(8). PMC: 6669060. DOI: 10.1093/gigascience/giz093. View

18.

Moonnumakal S, Fan L . Bronchiolitis obliterans in children. Curr Opin Pediatr. 2008; 20(3):272-8. DOI: 10.1097/MOP.0b013e3282ff62e9. View

19.

. [Consensus on the diagnosis and treatment of bronchiolitis obliterans in children]. Zhonghua Er Ke Za Zhi. 2013; 50(10):743-5. View

20.

Wu P, Li X, Jiang W, Yin G, Lei A, Xiao Q . Hypoxemia is an independent predictor of bronchiolitis obliterans following respiratory adenoviral infection in children. Springerplus. 2016; 5(1):1622. PMC: 5030207. DOI: 10.1186/s40064-016-3237-7. View