All issues > Volume 32(8); 1989

Original Article

J Korean Pediatr Soc. 1989;32(8):1064-1073. Published online August 31, 1989.

Unusual Forms of Pulmonary and Extrapulmonary Manifestations of Mycoplasmal Pneumonia.

Young Soo Lee¹, Chang Ho Hong¹, Chul Lee¹, Sung Gyu Lee¹

¹Department of Pediatrics, Yonsei University, College of Medicine, Seoul, Korea

Received: December 12, 1988;  Accepted: March 7, 1989.

Abstract

A clinical study was performed on 145 patients admitted to the Departement of Pediatrics, Yong Dong Severance Hospital between July, 1984 and June, 1987 with the diagnosis of Mycoplasmal pneumonia. This diagnosis was done when chest X-ray or auscultation of the chest showed signs of pneumonia. Patients with cold agglutinin titrations of 1:64 or titrations with four fold increase during follow up had Indirect Hemagglutination Test done for Mycoplasma pneumoniae. The authors studied 57 cases among these patients who showed unusual forms of pulmonary and extrapulmonary manifestations with the following results. 1) X-ray showed air-space pneumonia in 73.1% with a preponderance of segmental or lober distribution and hilar lymphadenopathy was present in 31.0%.When lobar pneumonia was present, it showed a preponderance for the right lower lobe. 2) Combined pulmonary manifestations are asthma, sinusitis, otitis media, croup and massive pleural effusions. 3) There were seven difficult cases of pulmonary manifestations. One case revealed pleural effusion localized in the anterior mediastinum which was suspected as anterior mediastinal tumor. Another case showed migratory infiltration which was difficult to differentiate from Loeffler’s pneumonia. 4) Extrapulmonary complications included hepatitis which occurred in 22 cases (15.2%), skin rashes in 7 cases(4.8%) and hematuria in 6 cases(4.1%) of which no biopsy was performed, one case of hematuria had coexisting hepatitis and myocarditis. Therefore, in school-aged children with pneumonia showing unusual manifestations, extra- pulmonary or pulmonary complications, we should provide early adequate therapy and prevent life threatening complications with testing Mycoplasma pneumoniae antibody.

Keywords :Mycoplasma Pneumoniae