Korean J Pediatr.  2018 Aug;61(8):258-263. 10.3345/kjp.2018.61.8.258.

Increased procalcitonin level is a risk factor for prolonged fever in children with Mycoplasma pneumonia

• Jeong JE
• Soh JE
• Kwak JH
• Jung HL
• Shim JW
• Kim DS
• Park MS
• Shim JY

• KMID: 2419562
• DOI: http://doi.org/10.3345/kjp.2018.61.8.258

Abstract

PURPOSE
Macrolide-resistant Mycoplasma pneumoniae pneumonia (MPP) is characterized by prolonged fever and radiological progression despite macrolide treatment. Few studies have examined serum procalcitonin (PCT) level in children with MPP. We aimed to investigate the association of acute inflammation markers including PCT with clinical parameters in children with MPP.
METHODS
A total of 147 children were recruited. The diagnosis of MPP relied on serial measurement of IgM antibody against mycoplasma and/or polymerase chain reaction. We evaluated the relationships between C-reactive protein (CRP), PCT, and lactate dehydrogenase (LDH) levels and white blood cell (WBC) counts, and clinical severity of the disease. We used multivariate logistic regression analysis to estimate the odds ratio for prolonged fever (>3 days after admission) and hospital stay (> 6 days), comparing quintiles 2-5 of the PCT levels with the lowest quintile.
RESULTS
The serum PCT and CRP levels were higher in children with fever and hospital stay than in those with fever lasting ≤ 3 days after admission and hospital stay ≤ 6 days. CRP level was higher in segmental/lobar pneumonia than in bronchopneumonia. The LDH level and WBC counts were higher in children with fever lasting for >3 days before compared to those with fever lasting for ≤ 3 days. The highest quintile of PCT levels was associated with a significantly higher risk of prolonged fever and/or hospital stay than the lowest quintile.
CONCLUSION
Serum PCT and CRP levels on admission day were associated with persistent fever and longer hospitalization in children with MPP.

Keyword

Mycoplasma pneumoniae; Pneumonia; Procalcitonin; Drug resistance; Child

MeSH Terms

Bronchopneumonia
C-Reactive Protein
Child*
Diagnosis
Drug Resistance
Fever*
Hospitalization
Humans
Immunoglobulin M
Inflammation
L-Lactate Dehydrogenase
Length of Stay
Leukocytes
Logistic Models
Mycoplasma pneumoniae
Mycoplasma*
Odds Ratio
Pneumonia
Pneumonia, Mycoplasma*
Polymerase Chain Reaction
Risk Factors*
C-Reactive Protein
Immunoglobulin M
L-Lactate Dehydrogenase