학동 전기의 소아 Mycoplasma pneumoniae 폐렴의 임상적 고찰 = Clinical Study of Patients with Mycoplasma Pneumoniae Pneumonai in Preschool Aged Children

다국어 초록 (Multilingual Abstract)

We studied 181 cases of pneumonia in children above 2 years of age who were admitted to the pediatric ward of Chung-Ang medical Center between March 1, 1993 and February 28, 1994. Of these cases, 78 cases were diagnosed as having Mycoplasma pneunomiae pneumonia, based on the result of the Mycoplasma antibody titer(I.H.A. test). We performed clinical studies of 50 preschool aged patients of Mycoplasma pneunoniae pneumonia patients. These results were compaired with patients above 6 years of age.
The results were as follows :
1) Among the total 181 cases with pneumonia, the incident of M. pneumoniae pneumonia was found in 27.2%(78 cases). The incidence of preschool aged M. pneumoniae pneumonia was 17.4% (20cases), and the peak distribution of age was below 4 years of age(35 cases;44.9%).
2) Male to female ratio was 1.5 : 1.
3) Monthly distribution showed a high frequency in November(9cases;18%), and seasonal distribution showed a high frequency in winter(12,1,2)(20cases;40%). That is similar to the seasonal distribution patients of above 6 years of age.
4) The M. pneumoniae pneumonia mostly had developed 7 days later from onset, and mean of duration was 5.5days. o significant difference in duration between children below 6 years of age an those above 6 years of age(p<0.05).
5) The most frequent symptom was cough(49cases:98%), and then followed by fever, fatigue, rhinorrhea. Rhinorrhea was more than patients below 6 years of age, but headache was more than patients above 6 years of ago.
6) The most frequent physical findings was rale(31cases:62%), and then followed by throat injection, tonsilar hypertrophy, wheezing, hepatomegaly, cervical lymph node enlargement, but normal findings were observed in 10 cases(20%) of patients. The result was more than patients above 6 years of age(7.1%).
7) WBC counts were 5,000 to 9,999/m㎥ in 58% of patients, and neutrophile was less than 70% in 86%, and CRP was positive in 56%, and increased ESR(>20mm/Hr) was noted in 88%. These results were similar to results of patients above 6 years of age.
8) Cold agglutinin titers were higher than 1:64 in 56% of patients. Mycoplasma antibody titer were noted in a high frequency in 1:1280. These results were similar to results of patients above 6 years of age.
9) Among the chest X-ray findings, bronchopneumonia(24%), segmental pneumonia(20%), intersitial pneumonia(20%), lobar pneumonia(18%) were noted, and pleural effusion was noted in 8%. The most common infiltrated site was right lower lobe and left lower lobe(10 cases;20%). Among the chest X-ray findings in patients above 6 years of age, segmental pneumonia(25%), lobar pneumonia(25%), interstitial pneumonia(17.8%), bronchopneumonia(14.3%) were noted, and pleural effusion was noted in 3.6%. The most common infiltrated site was left lower lobe(9 cases;37.5%).
10) As for the the complication and concomittant illness, asthmatic bronchitis, pleural effusion, hepatitis, skin rash, chronic sinusitis, thrombocytosis were noted. These results were similar to result of patients above 6 years of age, but hepatitis was not noted in patients above 6 years of age.
11) Mean hospital duration in children below 6 years of age was 7.59(±2.69), in that above 6 years of age was 7.09(±2.19), which was not statstically significant(p>0.05).