Early clinical signs of pulmonary embolism (PE) in children with severe Mycoplasma pneumoniae pneumonia (SMPP) include nonspecific prolonged fever, elevated inflammatory markers, increased D-dimer, and cardiovascular complications.
In this retrospective study of 199 children with SMPP, 100 had pulmonary embolism and 99 served as controls, with similar ages in the two groups.
PE was diagnosed on average 17 days after symptom onset in children with SMPP.
Longer duration of fever was independently associated with PE in children with SMPP.
Extrapulmonary symptoms were independently associated with PE, with about 3.5-fold higher odds.
Higher neutrophil count (NEU) and erythrocyte sedimentation rate (ESR) were independently associated with PE.
Lower APTT and higher D-dimer levels were independently associated with PE.
Cardiovascular complications were independently associated with PE and had the largest odds ratio, though with a wide confidence interval.
D-dimer had the largest AUC among identified factors for discriminating PE, with moderate sensitivity and specificity.
This study looked at children hospitalized with severe Mycoplasma pneumoniae pneumonia, a common bacterial lung infection in kids, to find out what distinguishes those who also developed a blood clot in the lungs (pulmonary embolism) from those who did not. Researchers compared 100 children with a lung clot to 99 without one at a children's hospital in China. The clots were typically found about 17 days after symptoms began. Children with lung clots were more likely to have a longer fever, symptoms outside the lungs, higher inflammation markers (neutrophil count and ESR), a shorter clotting time (APTT), higher D-dimer (a blood marker of clotting), and heart or blood vessel complications. Of these, D-dimer was best at telling the two groups apart, but it was imperfect, correctly identifying about 75% of children with clots and about 74% of those without. This research suggests that in children with severe Mycoplasma pneumonia, a prolonged fever, rising inflammatory and clotting markers, and cardiovascular problems may be early warning signs worth attention. Because the study was retrospective, done at one hospital, and the clot-group was selected rather than reflecting all patients, these findings show associations and are not proof of cause, and would need confirmation in other settings.
Chang X, Zhang L, Zhang Z, Tang X, Zhao M, Li Q, et al.. (2026). Factors associated with pulmonary embolism in children with severe Mycoplasma pneumoniae pneumonia.. Frontiers in immunology. https://doi.org/10.3389/fimmu.2026.1900602