Zhang et al identified risk factors for refractory mycoplasma pneumonia in children. These can help to identify a patient who may benefit from more aggressive management. The authors are from Zhejiang Univerisity in Hangzhour, China.
Refractory Mycoplasma pneumoniae pneumonia was defined as an infection showing clinical and radiological deterioration despite macrolide antibiotic therapy.
Patients with refractory mycoplasma pneumonia tended to have more severe presentation, a higher incidence of extrapulmonary complications and more serous radiological findings.
Patient selection: 1.9 to 8.0 years of age with PCR positive for Mycoplasma pneumoniae
Risk factors from multiavariate analysis:
(1) serum C reactive protein (CRP) >= 16.5 mg/L
(2) serum LDH >= 417 IU/L
(3) serum IL-6 >= 14.75 pg/mL
Additional findings may include:
(1) percent neutrophils >= 68.6%
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