Predictive value of bronchoscopy combined with CT score for refractory mycoplasma pneumoniae pneumonia in children

Abstract

Abstract Introduction Mycoplasma pneumoniae pneumonia (MPP) is prevalent in paediatric patients and can progress to refractory mycoplasma pneumoniae pneumonia (RMPP). Objective To assess the predictive value of bronchoscopy combined with computed tomography (CT) score in identifying RMPP in children. Methods A retrospective analysis was conducted on 244 paediatric patients with MP, categorising them into RMPP and general mycoplasma pneumoniae pneumonia (GMPP) groups. A paired t-test compared the bronchitis score (BS) and CT score before and after treatment, supplemented by receiver operating characteristic (ROC) analysis. Results The RMPP group showed higher incidences of extrapulmonary complications and pleural effusion (58.10% and 40%, respectively) compared with the GMPP group (44.60%, p = 0.037 and 18.71%, p < 0.001, respectively). The CT scores for each lung lobe were statistically significant between the groups, except for the right upper lobe (p < 0.05). Correlation analysis between the total CT score and total BS yielded r = 0.346 and p < 0.001. The ROC for BS combined with CT score, including area under the curve, sensitivity, specificity, and cut-off values, were 0.82, 0.89, 0.64, and 0.53, respectively. Conclusion The combined BS and CT score method is highly valuable in identifying RMPP in children.

Keywords

• Mycoplasma pneumoniae pneumonia
• Computed tomography score
• Bronchitis score
• Bronchoalveolar lavage
• Children