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Article in Japanese

Verification of steroid therapy for Mycoplasma pneumoniae pneumonia in pediatric patients

Mari KOROKI1), Yoshimitsu GOTOH1), Koji KANDA1), Yasuhiro KONDO1)

One hundred and seventy nine patients with Mycoplasma pneumoniae pneumonia were admitted to this hospital from December 1, 2012, to February 6, 2017. Of them, 135 (75%) used steroids, and 20 had recurrent fever. Their clinical characteristics were examined and divided into severe (lactate dehydrogenase [LDH] level of >480 IU/L and 37.5 °C that continued for 7 days) and mild pneumonia. It was impossible to state any difference in the period of fever and hospitalization as a result of examination with or without steroid administration in the mild pneumonia group. Among the 118 patients in the steroid administration group, 11 had recurrent fever that decreased significantly with age (5 vs. 8 years of age, p=0.034). There also was a short time interval between the onset of fever and steroid administration (5 vs. 6 days, p=0.022). Among 17 patients treated with steroids for severe pneumonia, with or without recurrence,nine in the reheating group had significantly higher LDH levels than those in the non-reperfusion group (554 IU/L vs. 489 IU/L, p=0.027). The LDH level contributing to reheating was calculated using the receiver operating characteristic curve. Based on an LDH level of ≥ 587.5 IU/L, the sensitivity and specificity was 100% and 44.4%, respectively (likelihood ratio, 1.8). Based on these data, this study could not demonstrate the usefulness of steroids in patients with mild pneumonia. Conversely, the administration of steroids at an early stage may induce recurrence. Therefore, steroids should not be used in patients with mild pneumonia.

1) Department of Pediatrics, Nagoya Second Red Cross hospital

Key words Mycoplasma pneumoniae pneumonia, steroid treatment, childhood pneumonia
Received August 13, 2018
Accepted April 23, 2019

31 (3):227─233,2019