Mycoplasma pneumoniae–Associated Bronchiolitis Obliterans Following Acute Bronchiolitis

Abstract

The characteristics of Mycoplasma pneumonia (M. pneumoniae)-associated bronchiolitis obliterans (BO) are not well known. We retrospectively reviewed 17 patients with M. pneumoniae–associated BO. All patients had M. pneumoniae–associated acute bronchiolitis prior to the development of BO. In the acute bronchiolitis stage, all patients had fever and cough; six patients also had wheezing and dyspnoea. BO was diagnosed approximately 1.5–8 months later based on clinical manifestations and chest high-resolution computed tomography (HRCT) findings. All patients presented with wheezing and/or dyspnoea at the time of diagnosis of BO. HRCT findings included mosaic attenuation, pronounced air trapping, central bronchiectasis and emphysema, according to disease severity. Lung function tests revealed mild to severe airway obstruction. Fourteen of 17 patients had a greater than 12% increase in forced expiratory volume in 1 second values after taking salbutamol. All patients had positive allergy test results and family or personal history of atopic disease. Four patients had a history of asthma before M. pneumonia bronchiolitis. Asthma was diagnosed before, at the time of or after the diagnosis of BO in 11 cases. M. pneumoniae–associated BO may therefore develop following M. pneumonia bronchiolitis and overlap with asthma.

Unresolved atelectasis in refractory Mycoplasma pneumoniae pneumonia: Predictive factors and the influence of corticosteroids and bronchoscopy lavage therapy

“…MPP is a common community-acquired pneumonia in children, and RMPP is a well-known condition particularly in North China. RMPP can lead to unresolved atelectasis, and unresolved atelectasis is associated with AO which has been reported mainly in our previous studies [2,7,8] . To our knowledge, ours is the rst study to determine the factors predicting atelectasis in pediatric RMPP and to evaluate the in uence of methylprednisolone and BLT on atelectasis development in children with RMPP.…”

“…Our results showed that the bronchial lumen was obstructed by mucus plugs even bronchial cast in patients who developed atelectasis, and that AO developed quickly, if the mucus plug was not removed (data not shown). However, once AO develops, atelectasis cannot be reversed [2,8] ; therefore, timely BLT to eliminate the mucus plugs is reasonable to prevent atelectasis on the early stage in pediatric RMPP. In addition, some patients had to receive bronchoscopic interventional therapy such as balloon dilatation because of atelectasis caused by AO or airway stenosis on the late stage in group A.…”

“…Some of RMPP sequelae patients nally receive lobectomy. However, there have been only a few reported cases of MPP-associated AO [7,8] , and the data on AO caused by RMPP in large population are scarce.…”

Mycoplasma pneumoniae​ pneumonia associated thrombosis at Beijing Children’s Hospital

“…community-acquired pneumonia (CAP) cases in children [1][2][3] , which is traditionally described as mild and self-limited; however, in the near ten years, many refractory, severe, fulminant or even fatal cases of MPP have been reported particularly in Eastern Asia [4][5][6][7] . In addition, MPP can lead to some complications such as necrotizing pneumonia (NP) [8] , airway obliterans (AO) [4,7,9] , hemolytic anemia [10] , and thrombosis [11,12] .…”

Clinical features of severe mycoplasma pneumoniae pneumonia with pulmonary complications in childhood: a retrospective study.

“…Although MP infection was traditionally thought to be self limited with a good outcome, the incidence of severe mycoplasma pneumoniae pneumonia (SMPP) case has gradually increased in recent years,and the change was from 0.7% in 2006 to 35% in 2016 [1]. Children with SMPP have long hospitalization, high medical expenses and may have long-term complications such as atelectasis, bronchiectasis, bronchitis obliterans and bronchiolitis obliterans [3][4][5]. There are no well-defined and unified diagnostic criteria for pediatric SMPP, and patients who were definitely diagnosed as MPP satisfied the criteria of severe CAP according to "Guidelines for management of community-acquired pneumonia in children" [6] could be confirmed as SMPP.…”