Pediatr Allergy Respir Dis.  1998 Mar;8(1):64-71.

The Development of Bronchiolitis obliterans after Mycoplasma pneumoniae Pneumonia: Relationship with Antibody Titer and X-ray Pattern

• Kim CK
• Chung CY
• Kim JS
• Hur G
• Lee HE
• Koh YY

Abstract

The aims of this study were to document bronchiolitis obliterans(BO), the long term pulmonary sequelae after mycoplasma pneumonia, and to evaluate the difference of development of BO according to antibody titer and X-ray pattern. Twenty five subjects who had mycoplasma pneumonia underwent high resolution CT(HRCT) 1.3 years(1.0-2.0 years) after the initial infection. Fifteen boys and 10 girls, with mean age of 6.3 years(3-15 year) at the time of the infection, were included. The clinical diagnosis of Mycoplasma pneumoniae(M. pneumoniae) pneumonia was confirmed by a fourfold or higher rise in the antibody titers between acute and convalescent phase or a single very high titers(> or = 1:640) and abnormal chest radiographs. The subjects were divided into two groups as high titer group(antibody titer 1:5120 1:20480, n=15) and low titer group(antibody titer 1:640-1:2560, n=10). Nine of 25 subjects(36.0%) demonstrated BO findings on HRCT which included mosaic perfusion in 8 of 9 subjects(88.9%), bronchiectasis in 6(66.7%), mosaic perfusion associated with bronchiectasis in 6(66.7%), bronchial wall thickening in two(22.2%), and decreased pulmonary vascularity in one(11.1%). Those findings were more commonly seen in high titer group compared to low titer group[53.3%(8/15) vs 10.0%(1/10), P<0.05] and lobar type compared to linear type[58.0%(7/12) vs 15.4% (2/13), P<0.05]. The involved areas on HRCT exactly corresponded with initially involved area on chest radiographs in 8 of 9 subjects (88.9%). The development of BO was closely related to the M. pneumoniae pneumonia and was noted significantly in individuals with high antibody titer and lobar type x-ray pattern. We suggest that it is necessary to pay attention to the development of BO after M. pneumoniae pneumonia with high antibody titer and lobar type x-ray pattern.

Keyword

Bronchiolitis obliterans; Mycoplasma pneumoniae pneumonia; Antibody titers; X-ray pattern; High Resolution CT

MeSH Terms

Bronchiectasis
Bronchiolitis Obliterans*
Bronchiolitis*
Diagnosis
Female
Humans
Mycoplasma pneumoniae*
Mycoplasma*
Perfusion
Pneumonia*
Pneumonia, Mycoplasma*
Radiography, Thoracic