In recent years, the infection rate of Mycoplasma pneumoniae in children has gradually increased. Mycoplasma pneumoniae encephalitis (MPE) seriously threatens children’s health, but studies on its clinical characteristics and prognosis are limited. This study summarized the clinical features of paediatric MPE and explored its prognostic factors. A retrospective single-center study was conducted on children with MPE who were treated between January 2016 and June 2024. All children underwent Glasgow Outcome Scale (GOS) assessment at 6 months after diagnosis. Patients with GOS scores of 4–5 were assigned to the good outcome group, and those with scores of 1–3 to the poor outcome group. Early onset was defined as the onset of neurological symptoms within 7 days of fever onset, and late onset as symptoms after 7 days. Characteristics and prognostic factors were subsequently analysed. Among 71 children, the median age was 7 years; 43 males and 28 females were affected, and 36 had winter onset. Thirty-one patients had early-onset disease, and 40 patients had late-onset disease. Compared with early-onset patients, late-onset patients had a younger median age, a greater proportion of patients with cough symptoms, a lower proportion of patients with vomiting symptoms, and a greater proportion of patients with elevated D-dimer levels, elevated serum IgM levels and severe pneumonia. Nine children had poor prognoses, with a GOS score of 3. Multivariate analysis revealed that a reduced level of consciousness at onset (odds ratio OR = 20.978; P = 0.006), elevated serum IgG levels (OR = 23.813; P = 0.030), and invasive mechanical ventilation (OR = 39.275; P = 0.005) were independent risk factors affecting the prognosis of children with MPE. The timing of anti-Mycoplasma pneumoniae or immunomodulatory treatment was not significantly correlated with prognosis. Most children with MPE have a good prognosis. A reduced level of consciousness at onset, elevated serum IgG levels, and invasive mechanical ventilation may indicate a poor prognosis and help identify severe cases early. Future research should focus on the pathogenesis of MPE and explore novel therapeutic approaches to improve the prognosis of children with MPE.
Zhang et al. (Sat,) studied this question.