Clinical Features of Severe Mycoplasma vs Bacterial Pneumonia

Research Article| September 01 2025 Clinical Features of Severe Mycoplasma vs Bacterial Pneumonia Available to Purchase AAP Grand Rounds (2025) 54 (3): 32. https://doi.org/10.1542/gr.54-3-32 Views Icon Views Open Menu Article contents Figures & tables Video Audio Supplementary Data Peer Review Share Icon Share Facebook X LinkedIn Email Tools Icon Tools Open Menu Get Permissions Cite Icon Cite Search Site Citation Clinical Features of Severe Mycoplasma vs Bacterial Pneumonia. AAP Grand Rounds September 2025; 54 (3): 32. https://doi.org/10.1542/gr.54-3-32 Download citation file: Ris (Zotero) Reference Manager EasyBib Bookends Mendeley Papers EndNote RefWorks BibTex toolbar search toolbar search search input Search input auto suggest filter your search All PublicationsAll JournalsAAP Grand RoundsPediatricsHospital PediatricsPediatrics In ReviewNeoReviewsAAP NewsAll AAP Sites Search Advanced Search Topics: bacterial pneumonia, mycoplasma, pneumonia, signs and symptoms Source: Liu J, Bao B, Zhang T, et al. Comparative analysis of the clinical characteristics of severe Mycoplasma pneumoniae pneumonia and severe bacterial pneumonia in children. BMC Pediatr. 2025;25(1):439; doi: https://doi.org/10.1186/s12887-025-05804-4.Google Scholar Investigators from Zhengzhou University and Henan University of Chinese Medicine, both in Zhengzhou, China, conducted a retrospective study to compare the demographic and clinical characteristics of children with severe Mycoplasma pneumoniae (MP) to those with either Streptococcus pneumoniae (SP) or Haemophilus influenzae (HI) pneumonia. Study participants were patients ≤18 years old admitted to a single center in China between January 2020 and October 2024 with severe pneumonia caused by MP, SP, or HI. Specific criteria were used to define severe pneumonia, including fever for >5 days, respiratory distress, oxygen saturation <92%, general signs of toxicity, and/or CT findings. MP cases were confirmed based on a positive PCR assay of a throat swab or bronchoalveolar lavage fluid (BALF) sample, and SP and HI were confirmed as the causative agent using sputum or BALF culture results. The medical records of study children were reviewed and demographic and clinical information abstracted. Data on laboratory tests during the first 24 hours of admission, chest CT findings, and bronchoscopy results also were collected. Characteristics of patients in the 3 groups were compared using t-tests, ANOVA, chi square, and rank sum tests. There were 316 children included in the analysis, 130 with MP severe pneumonia, 81 with SP, and 105 with HI. Children with MP severe pneumonia were significantly older than those in the SP and HI group (median age, 45.5, 18.0, and 14.0 months, respectively; P <0.001); those with SP were older than those with HI pneumonia (P = 0.049). Patients with MP had a median of 7.0 days of fever, compared to 4.0 days and 5.0 days, respectively, for those with SP or HI severe pneumonia (P <0.001). White blood cell counts were significantly lower in those with MP pneumonia than those with SP or HI pneumonia (median, 8.61, 10.07, and 10.46 x 109/L, respectively; P <0.001), while erythrocyte sedimentation rates and IL-6 levels were significantly higher. Chest CTs were obtained on all study children. "Patchy shadows" were more likely to be unilateral in those with MP, than in patients in the SP and HI groups (35.5%, 9.9%, and 1.0%, respectively; P <0.001). Lung consolidation was present in 73.8% of children with MP severe pneumonia, 39.5% of those with SP, and 28.6% of patients with HI (P <0.001). Bronchoscopy was performed in 79 (61%) of children in the MP group, 31 (38.4%) of those with SP, and 27 (25.7%) of children with HI. Among these children, sputum plugs were more commonly seen in those with MP than in patients in the other 2 groups (P = 0.046). The authors conclude that children with severe pneumonia caused by MP had different characteristics and clinical findings than those with SP or HI as the... You do not currently have access to this content.