Early Additional Immune-Modulators for Mycoplasma pneumoniae Pneumonia in Children: An Observation Study / 감염과화학요법
Infection and Chemotherapy
; : 239-247, 2014.
Article
in En
| WPRIM
| ID: wpr-116975
Responsible library:
WPRO
ABSTRACT
BACKGROUND:
Mycoplasma pneumoniae (MP) pneumonia is a self-limiting disease, but some patients complain of progressive pneumonia, despite of appropriate antibiotic treatment. We aimed to introduce the role of immune-modulators (corticosteroid and/or intravenous immunoglobulin, IVIG) treatment for childhood MP pneumonia based on previous our experiences. MATERIALS ANDMETHODS:
A retrospective case series analysis for 183 children with MP pneumonia was performed. MP pneumonia patients were diagnosed by two Immunoglobulin M (IgM) tests the micro-particle agglutination method (> or =140) and the cold agglutination test (> or =14), and were examined twice at the initial admission and at discharge. Among 183 MP pneumonia patients, 90 patients with persistent fever for over 48 hours after admission or those with severe respiratory symptoms and signs received additional prednisolone (82 patients, 1 mg/kg/day) or intravenous methylprednisolone (8 patients, 5-10 mg/kg/day) with antibiotics. Four patients with aggravated clinical symptoms and chest radiographic findings after corticosteroid treatment received IVIG (1 g/kg/day, 1-2 doses).RESULTS:
Mean age of 183 patients was 5.5 +/- 3.2 years (6 months-15 years), and the male female ratio was 1.11 (9687). Fifty-seven patients (31%) were seroconverters and 126 seropositive patients showed increased diagnostic IgM antibody titres during admission (over 4 folds). The majority of the patients who received corticosteroids (86/90 cases) showed rapid defervescence within 48 hours with improved clinical symptoms, regardless of the used antibiotics. Also, 4 patients who received additional IVIG improved both clinically and radiographically within 2 days without adverse reaction.CONCLUSIONS:
In the era of macrolide-resistant MP strains, early additional immune-modulator therapy with antibiotics might prevent from the disease progression and reduce the disease morbidity without adverse reaction.Key words
Full text:
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Index:
WPRIM
Main subject:
Pneumonia
/
Pneumonia, Mycoplasma
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Immunoglobulin M
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Immunoglobulins
/
Agglutination Tests
/
Methylprednisolone
/
Prednisolone
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Radiography, Thoracic
/
Retrospective Studies
/
Immunoglobulins, Intravenous
Type of study:
Observational_studies
Limits:
Child
/
Female
/
Humans
/
Male
Language:
En
Journal:
Infection and Chemotherapy
Year:
2014
Type:
Article