Clinical relevance and characteristics of pleural effusion in patients with Mycoplasma pneumoniae pneumonia

Cha, Seung‐Ick; Shin, Kyung-Min; Jeon, Kyung-Nyeo; Yoo, Seung Soo; Lee, Jaehee; Lee, Shin-Yup; Kim, Chang‐Ho; Park, Jae Yong; Jung, Tae-Hoon

doi:10.3109/00365548.2012.681696

Cited by 19 publications

(21 citation statements)

References 19 publications

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“…Higher IL17A expression in BALF is correlated with general MPP and MPP without pleural effusion; lower IL17A expression in BALF is correlated with refractory MPP and MPP with pleural effusion. Similar to our results, it has been reported that MPP children with pleural effusion may have a more severe form of MPP with longer hospital stay and more commonly usage of corticosteroid comparing to those without pleural effusion 5 . We put forward the hypothesis that low IL17A levels in BALF may suggest severe MPP in children and more likely to become MPP with pleural effusion and refractory MPP.…”

Section: Discussionsupporting

confidence: 92%

“…Severe MPP may have pleural effusion, longer fever duration and refractoriness. It has been reported that MP patients with pleural effusion may have a more severe form MPP compared to those without pleural effusion 5 . The mechanism of refractory MPP is not clear, one possible cause is the inflammatory response caused by immune abnormalities.…”

Section: Introductionmentioning

confidence: 96%

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Interleukin 17A as a good predictor of the severity of Mycoplasma pneumoniae pneumonia in children

Yang

Meng

Kuo

et al. 2017

Sci Rep

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Early distinction between severe Mycoplasma pneumoniae pneumonia (MPP) and mild MPP is still difficult. The aim of this study was to analyze cytokines in bronchoalveolar lavage fluid (BALF) and explore predicting factors of severe MPP in children. Retrospective analysis was performed on 150 children with MPP or bronchial foreign body (FB) admitted in our hospital. The mRNA levels of IL17A were found significantly lower in severe MPP group comparing with mild MPP group or FB group. However, no significant difference was found in the levels of IL4, IL10 or interferon beta1 (IFNβ1) between the two groups. Receiver operator characteristic (ROC) curve analysis showed that IL17A can be used to distinguish severe MPP from mild MPP. These results were confirmed in a validation cohort including 40 MPP children from another hospital. IL17A levels were correlated with some clinical characters, such as refractoriness and pleural effusion. Lower IL17A levels were more likely to be found in refractory MPP children or in MPP children with pleural effusion. Moreover, the protein levels of IL17A in BALF were also found greatly decreased in children with severe MPP. Thus, decreased IL17A levels in BALF may be a valuable biomarker to identify severe MPP in children.

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Section: Discussionsupporting

confidence: 92%

Section: Introductionmentioning

confidence: 96%

Interleukin 17A as a good predictor of the severity of Mycoplasma pneumoniae pneumonia in children

Yang

Meng

Kuo

et al. 2017

Sci Rep

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“…On the contrary, they observed elevated ADA levels in five patients, but our patient's ADA level was low, acid fast bacilli stains were negative and the neutrophilic exudate culture was negative for bacterial or viral organisms [21] . Retrospective analysis done by Linz DH et al; showed five patients had pleural effusion which were moderate to large size, two patients had diagnostic thoracentesis which showed exudate with neutrophilic predominant effusion [22] .…”

Section: Discussioncontrasting

confidence: 77%

Rare complicated parapneumonic effusion, Mycoplasma pneumoniae with new-onset lupus flare: Case report and literature review

Bajantri

Shaikh

Duncalf

et al. 2017

Respiratory Medicine Case Reports

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Mycoplasma pneumoniae has been associated with respiratory tract infections. Mycoplasma pneumoniae pneumonia–related pleural effusion is rarely reported. Extra-pulmonary abnormalities such as encephalitis, myocarditis, glomerulonephritis, and myringitis have been reported. However pulmonary manifestations in systemic lupus erythematosus include pneumonitis, pleurisy, interstitial lung disease, and thromboembolic disease. We present the case of a 26-year-old male who came for evaluation of fever, cough, and shortness of breath with right-sided chest pain. He was found to have right-side loculated complicated parapneumonic effusion and underwent drainage with a pleural catheter followed by fibrinolytic therapy. He was then found to have new-onset systemic lupus erythematosus concomitant with Mycoplasma pneumonia, leading to lupus flare and lupus nephritis. He responded well to levofloxacin, steroids, hydroxychloroquine, and mycophenolate, with complete resolution of loculated pleural effusion and symptom improvement. Our case describes the rare combination of Mycoplasma pneumoniae pneumonia, parapneumonic pleural effusion, and lupus flare with lupus nephritis. Early identification and treatment can lead to better out come in young patients.

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“…We checked for consolidation, ground glass opacity (GGO), centrilobular nodules, bronchial wall thickening, cavity, and pleural effusion. Similar to previous studies 20 21 , patients were classified into four levels by measuring the maximum fluid thickness between the visceral and parietal pleurae on a CT scan: no pleural effusion; small pleural effusion, fluid thickness of 5-20 mm; moderate pleural effusion, fluid thickness of 21-50 mm; and large pleural effusion, fluid thickness >50 mm.…”

Section: Methodsmentioning

confidence: 99%

Clinical Characteristics of Community-Acquired Viridans Streptococcal Pneumonia

et al. 2015

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BackgroundViridans streptococci (VS) are a large group of streptococcal bacteria that are causative agents of community-acquired respiratory tract infection. However, data regarding their clinical characteristics are limited. The purpose of the present study was to investigate the clinical and radiologic features of community-acquired pneumonia (CAP) with or without parapneumonic effusion caused by VS.MethodsOf 455 consecutive CAP patients with or without parapneumonic effusion, VS were isolated from the blood or pleural fluid in 27 (VS group, 5.9%) patients. Streptococcus pneumoniae was identified as a single etiologic agent in 70 (control group) patients. We compared various clinical parameters between the VS group and the control group.ResultsIn univariate analysis, the VS group was characterized by more frequent complicated parapneumonic effusion or empyema and bed-ridden status, lower incidences of productive cough, elevated procalcitonin (>0.5 ng/mL), lower age-adjusted Charlson comorbidity index score, and more frequent ground glass opacity (GGO) or consolidation on computed tomography (CT) scans. Multivariate analysis demonstrated that complicated parapneumonic effusion or empyema, productive cough, bed-ridden status, and GGO or consolidation on CT scans were independent predictors of community-acquired respiratory tract infection caused by VS.ConclusionCAP caused by VS commonly presents as complicated parapneumonic effusion or empyema. It is characterized by less frequent productive cough, more frequent bed-ridden status, and less common CT pulmonary parenchymal lesions. However, its treatment outcome and clinical course are similar to those of pneumococcal pneumonia.

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Clinical relevance and characteristics of pleural effusion in patients with Mycoplasma pneumoniae pneumonia

Cited by 19 publications

References 19 publications

Interleukin 17A as a good predictor of the severity of Mycoplasma pneumoniae pneumonia in children

Interleukin 17A as a good predictor of the severity of Mycoplasma pneumoniae pneumonia in children

Rare complicated parapneumonic effusion, Mycoplasma pneumoniae with new-onset lupus flare: Case report and literature review

Clinical Characteristics of Community-Acquired Viridans Streptococcal Pneumonia

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