Early Recognition And Management Of Pulmonary Embolism Related To Mycoplasma Pneumoniae Infections In Children: Two Case Reports And Literature Review

Objective: To explore the clinical characteristics and risk factors of mycoplasma pneumoniae (MP) infections complicated by pulmonary embolism in children. Methods: We report two cases of MP infections complicated by pulmonary embolism (PE). We also reviewed all reports of pulmonary emboli resulting from MP infections in the past fifteen years. Results: Two children with PE were enrolled: a 9-year-old girl presented with bloody effusion and hemoptysis and a 7-year-old boy with chest pain and hemoptysis. We found 7 case reports of MP infection with PE. Nine cases aged from 6 to 13 years were reported in the past 15 years, of which 7 cases were male and 2 female. Five patients had chest pain, three had hemoptysis, and two had bloody pleural effusions. Four patients had emboli in the veins of their lower limbs. The D-dimer levels were increased significantly in all patients. Anti-cardiolipin antibodies of seven cases were positive. Conclusion: MP infection may lead to a hyper-coagulative state and potential to thrombosis because of autoantibodies especially antiphospholipid antibodies. Early diagnosis with anti-coagulation and thrombolysis treatment actively is the key to a better prognosis.