The Incidence and Risk Factors of Extrapulmonary Manifestations in mycoplasma Pneumoniae Pneumonia

초록

Background:Mycoplasma pneumoniaepneumonia (MP) is a majorcause of community‐acquired pneumonia (CAP) in children and isknown to be associated with extrapulmonary manifestations (EPM).However, the incidence and risk factors associated with EPM is notknown in children. Methods:A retrospective study in 65,243 children with CAPbetween 2010 and 2015 at 23 nationwide hospitals was conductedin South Korea. Medical records were reviewed to collect informationregarding the clinical characteristics and radiological and laboratoryfindings. Therefore, 9,190 children with MP were enrolled for theanalysis. Logistic regression with multivariable analysis was per-formed to evaluate the risk factors associated with EPM of MP. Results:The mean age of the enrolled children with MP was64.3 ± 39.8 months, and boys were 49.5%. The incidence of EPM was23.9% and elevation of liver enzyme was shown in 18.1%,mucocutaneous manifestation in 4.4%, proteinuria in 4.1%, cardio-vascular and neurological manifestations in 0.4%, respectively, andarthritis and hematological manifestations in 0.2%, respectively.Logistic regression with multivariate analysis showed that muco-cutaneous manifestations were significantly increased with elevatedalanine aminotransferase (aOR 3.623, 93% CI 1.933‐6.790) andatopic sensitization (aOR 2.973, 93% CI 1.615‐5.475) and decreasedwith respiratory virus co‐infection (aOR 0.273, 93% CI 0.084‐0.887).Elevated liver enzymes were significantly associated with elevatedlactate dehydrogenase (aOR 3.055, 93% CI 2.257‐4.137) andpresence of pleural effusion (aOR 2.635, 93% CI 1.767‐3.930) andproteinuria with respiratory virus co‐infection (aOR 2.245, 93% CI1.113‐4.527). Conclusions:About 24% of children with MP accompaniedvarious EPM in Korean children. Since risk factors associated witheach EPM was different, it is necessary to evaluate the various clinicalaspects and findings of MP to predict and prepare for the occurrenceof EPM.