Background Cerebral infarction (CI) is a rare but severe complication of Mycoplasma pneumoniae pneumonia (MPP) in children. Objective This study aimed to explore the clinical characteristics and factors associated with CI in pediatric patients with MPP. Methods A retrospective cohort study of children with MPP was conducted between 2019 and 2023. Clinical characteristics, laboratory findings, and imaging results were collected and analyzed. Propensity score matching (PSM) was applied to reduce potential confounding, and Firth’s penalized logistic regression was performed as an exploratory analysis to assess associations between selected variables and CI. Results Among 2,947 children diagnosed with MPP, 9 (0.3%) developed CI. In the matched cohort, higher levels of C-reactive protein (CRP) and D-dimer were significantly associated with the occurrence of CI CRP: odds ratio (OR) = 1.08, p = 0.003; D-dimer: OR = 1.00026, p = 0.007. Receiver operating characteristic (ROC) analysis demonstrated that the combination of CRP and D-dimer showed good discriminatory performance for CI, with an area under the curve of 0.920 ( p 0.001). Conclusion Elevated CRP and D-dimer levels were associated with CI in children with MPP and may be useful for risk stratification. These findings highlight the potential interplay between inflammation and coagulation in CI complicating MPP. Further multicenter studies with larger sample sizes are required to validate these results and clarify their clinical utility.
Deng et al. (Mon,) studied this question.