A retrospective study

Abstract

This study aimed to investigate the inner linkage and mechanism ofMycoplasma pneumoniae (MP) infection and Kawasaki disease (KD), as well as the risk factors of outcome in this cohort of patients. A retrospective study was performed in 210 patients diagnosed with KD complicated with community acquired pneumonia (CAP) in Children’s Hospital, Zhejiang University School of Medicine from January 2014 to December 2017. They were divided into two groups based onMP infection: MP infection group (n=97) and non-MP infection group (n=113). We compared the variables of these two groups based on medical records. The MP infection group had higher ESR than the non-MP infection group. During hospitalization, the non-MP infection group had higher levels of WBC during hospital, LDH, PCT, and lower HBwhen compared to the MP infection group. No differences were found in the hs-CRP level, N%, PLT, ALT, CKMB, and cytokine levels (IL-2, IL-4, IL-6, IL-10, TNF-a, and IFN-g) between MP and non-MP infection group. Likewise, no difference was found in fever duration or hospital stays between them. Totally 19 patients in the infection group had CAAwith a rate of 19.59%; and 27 (23.89%) patients had CAA in the non-MP infection group. Unfortunately, no difference was found in CAA rate between the two groups. MP infection may occur simultaneously in children with Kawasaki disease. KD patients with MP infection tended to occur in older population. MP infection may not increase the risk of CAA, which still needs further large-scaled studies to confirm. Clinicians should be alert to KD patients with high level of ESR. MP should be screened and early treatment with macrolides should be given timely. Abbreviations: AHA = American heart association, ALB = albumin, ALT = alanine transaminase, CAA = coronary artery abnormalities, CAP = community acquired pneumonia, CKMB = creatine kinase MB activity, ELISA = enzyme-linked immunosorbent assay, ESR = erythrocyte sedimentation rate, HB = hemoglobin, hs-CRP = high sensitivity-C-reactive protein, IFN-g = interferon-g, IL = interleukin, IVIG = intravenous immunoglobulin, KD = Kawasaki disease, LDH = lactic dehydrogenase, MP =Mycoplasma pneumoniae, MPEPDs =MP-related extra-pulmonary diseases, MPP =Mycoplasma pneumoniae pneumonia, N% = neutrophils percentage, NPA = nasopharyngeal aspirate, PCR = polymerase chain reaction, PCT = procalcitonin, PLT = platelet, RMPP = refractory Mycoplasma pneumoniae pneumonia, SMPP = severe Mycoplasma pneumoniae pneumonia, TNF-a = tumor necrosis factor-a, WBC = white blood cell.