[Follow-up outcomes and influencing factors of Mycoplasma pneumoniae necrotizing pneumonia in children].

Authors

X L Li, Y Y Qi, A Z Lu, D Y Tian, X B Zhang

Published in

Zhonghua er ke za zhi = Chinese journal of pediatrics. Volume 64. Issue 9. Pages 1034-1040. Aug 17, 2026. Epub Aug 17, 2026.

Abstract

Objective: To investigate the clinical outcomes and prognostic factors in children with Mycoplasma pneumoniae necrotizing pneumonia (MPNP) at 1 year after discharge. Methods: This prospective cohort study enrolled 60 children with MPNP treated at the Department of Respiratory Medicine, Children's Hospital of Fudan University, between August 2023 and December 2024. Clinical, laboratory, and radiological data were collected during hospitalization. All patients were followed up for one year post-discharge, with serial assessments of symptoms, chest CT, and pulmonary function. Based on final CT findings, patients were categorized into good and poor prognosis groups. Univariate analysis, Lasso regression, and multivariate Logistic regression were used to identify independent predictors and construct a prediction model. Results: Among the 60 children (28 males, 32 females; age at presentation 6.0 (5.0, 8.0) years), 38 cases had good prognosis and 22 cases had poor prognosis. Compared with the good prognosis group, the poor prognosis had significantly higher proportions of acute-phase respiratory failure, intensive care unit admission, poor distal ventilation on bronchoscopy, necrotic cavity diameter ≥2 cm on imaging, ≥2/3 single-lobe involvement, multilobar consolidation, and moderate-to-large pleural effusion, as well as greater numbers of involved lobes and total CT scores (all P<0.05). At the 1-year follow-up, atelectasis occurred in all 22 cases (100.0%) in the poor prognosis group, with pulmonary cavity formation in 3 cases (13.6%) and abnormal pulmonary function in 8 cases (36.4%). Multivariate analysis identified poor distal ventilation on bronchoscopy (OR=9.29, 95%CI 2.03-60.46, P=0.003) and elevated lactate dehydrogenase (LDH) level (per 100 U/L increase, OR=2.16, 95%CI 1.42-3.90, P<0.001) as independent predictors of poor prognosis. The combined predictive model based on these two factors achieved an area under the curve of 0.93 (95%CI 0.87-0.99, P<0.001). Conclusions: A substantial subset of MPNP children still exhibit radiological sequelae and functional impairment one year after discharge. Acute-phase poor distal ventilation on bronchoscopy and markedly elevated serum LDH are independent predictors of poor prognosis. The prediction model combining these two factors demonstrates good discriminative ability.

PMID:
42605088
Bibliographic data and abstract were imported from PubMed on 17 Aug 2026.

Read full publication at:
Please sign in to see all details.

Stats

1-terrible, 9-excellent. How would you rate this publication? Sign in in to submit your rating.

Post a comment

You need to be signed in to post comments. You can sign in here.

Comments

There are no comments yet.