Late abnormal findings on high-resolution computed tomography after Mycoplasma pneumonia.

Abstract

The clinical course of Mycoplasma pneumonia is typically mild and self-limited. There are, however, several case reports of severe complication following this illness with considerable morbidity and mortality. This study was conducted to investigate, using high-resolution computed tomography (HRCT), the long-term pulmonary structural abnormalities after Mycoplasma pneumonia and to identify risk factors (chest radiograph findings, antibody titers, and host factors) that might increase the likelihood of developing the sequelae. Thirty-eight children requiring hospitalization attributable to Mycoplasma pneumonia were recruited by the retrospective examination of hospital records. They underwent HRCT after an interval of 1.0 to 2. 2 years. A control group of 17 children with the history of Mycoplasma upper respiratory infection was also studied after a similar interval. Abnormal HRCT findings were present in 37% (14/38) of the pneumonia group, compared with 12% (2/17) of the control group. The abnormalities in the pneumonia group, which appeared alone or in combination, included mosaic perfusion (n = 12), bronchiectasis (n = 8), bronchial wall thickening (n = 4), decreased vascularity (n = 1), and air trapping on expiratory scan (9 of 29 tested). The area affected by these abnormalities, usually involving 2 or more lobes, corresponded in all cases to the location of the infiltrate on chest radiograph at the time of pneumonia. Between subjects with abnormal HRCT (n = 14) and normal HRCT (n = 24) in the pneumonia group, significant differences were observed in age at the time of pneumonia (mean +/- standard deviation: 5.3 +/- 2. 0 years vs 7.7 +/- 3.4 years) and peak antimycoplasma antibody titer (geometric mean [range of 1 standard deviation]; 1:7943 [3126-19 953] vs 1:3093 [832-11 482]). We conclude that a considerable proportion of children with history of Mycoplasma pneumonia have abnormal findings on HRCT, suggestive of small airway obstruction and that younger age and higher antibody titer at the time of pneumonia may be risk factors for these sequelae.