Mycoplasma pneumoniae infections in children. Arch Dis Child

SUMMARY Details are given of all serologically confirmed Mycoplasma pneumoniae infections in children referred to Bristol hospitals during an epidemic lasting 18 months. 44 children, many below school age, had lower respiratory infections. The majority had cough and malaise which had failed to respond to antibiotics given before referral. Chest x-rays showed no pathognomonic features: segmental or patchy consolidation was common; 3 cases had lobar consolidation. Cold agglutinins were raised in 9 out of 12 cases. In the majority of cases the total leucocyte count was normal and the absolute neutrophil count raised. Mean duration of symptoms was 4-2 weeks (range 1-16). Treatment with erythromycin or tetracycline appeared to have little effect in most cases. Seven nonrespiratory manifestations were seen in 6 children. These were meningitis (2 cases), Stevens-Johnson syndrome (4 cases, 1 case complicated by toxic epidermal necrolysis), and acute haemolytic anaemia (1 case). Mycoplasna pneumoniae infections affect both the upper and lower respiratory tract and occur most frequently between the ages of 5 and 30 years (Couch, 1973). M. pneumoniae has been found to be an uncommon cause of pneumonia before school age (Foy et al., 1970) and infections in this age group are usually mild (Femald et al., 1975). This paper gives details of all serologically confirmed M. pneumoniae infections in children, many below school age, referred to Bristol hospitals during a recent epidemic. Manifestations of M. pneumoniae outside the respiratory tract are uncommon. Acute haemolytic anaemia (Barret-Connor, 1972), arthritis (Lambert, 1968), Stevens-Johnson syndrome (Cherry et al., 1975), pericarditis (Grayston etal., 1965), myocarditis (Grayston et al., 1967), hepatitis (Murray et al., 1975), meningitis, and other neurological disorders (Lerer and Kalavsky, 1973) have been described. Details of some of these unusual but serious mani-festations are presented. Patients and method