Clinical analysis of 124 cases of mycoplasma pneumoniae infection with conjunctivitis in children

Abstract

Objective: To explore the distribution characteristics of symptoms and signs of respiratory mycoplasma pneumoniae infection complicated with conjunctivitis in children of different age groups. Methods: A retrospective case series study was conducted. Data of children who were treated in Beijing Children's Hospital Affiliated to Capital Medical University from September 20, 2023 to November 30, 2023, had definite mycoplasma pneumoniae infection as confirmed by mycoplasma pneumoniae nucleic acid or mycoplasma pneumoniae IgM antibody test, and had conjunctivitis as the first diagnosis in ophthalmology department were continuously collected. The included children were divided into infant group (age<4 years), preschool group (age 4 to 6 years), and school-age group (age>6 years) for analysis. Information such as the time of ocular symptoms onset, the time of systemic symptoms onset, conjunctival sac secretion, subconjunctival hemorrhage, conjunctival congestion, corneal epithelial damage, co-infection with other pathogens, and treatment of all children was collected and compared among children of different age groups. Results: During this period, there were a total of 31 133 children with positive laboratory test results for mycoplasma pneumoniae. Among them, 835 children visited the ophthalmology department during the same period, and 124 cases (229 eyes) had conjunctivitis as the first diagnosis. The age was (5.43±2.83) years, including 72 males and 52 females. There were 37 cases (69 eyes) in the infant group, 48 cases (92 eyes) in the preschool group, and 39 cases (68 eyes) in the school-age group. Among the 229 eyes, 179 eyes (78.16%) had conjunctival secretion, all manifested as mucopurulent secretion; 12 eyes (5.24%) had corneal epithelial defect; and 26 eyes (11.35%) had subconjunctival hemorrhage. There was 1 eye (1.45%) with subconjunctival hemorrhage in the infant group, 16 eyes (17.39%) in the preschool group, and 9 eyes (13.24%) in the school-age group. The proportion of subconjunctival hemorrhage in the preschool group and school-age group was higher than that in the infant group (both P<0.05). Thirty-nine cases (31.45%) were found to have co-infection with viruses in laboratory tests, including influenza A virus, adenovirus, respiratory syncytial virus, and coxsackievirus. The proportion of children in all age groups with ocular symptoms first was higher than that with systemic symptoms first. There was no statistically significant difference among children in the three age groups in terms of whether there was conjunctival secretion, whether there was corneal epithelial damage, whether there was co-infection with viruses, and the interval between ocular symptoms and systemic symptoms onset (all P>0.05). Conclusions: The characteristic ocular manifestations of children with mycoplasma pneumoniae infection complicated with conjunctivitis are conjunctival congestion and subconjunctival hemorrhage, and the signs are more obvious in preschool children. The conjunctival sac secretion of such children with conjunctivitis is mostly manifested as mucopurulent. Ocular symptoms may be the first manifestation of mycoplasma pneumoniae infection.