Spectrum of clinical and radiographic findings in pediatric mycoplasma pneumonia.
Clinical symptoms in mycoplasma infection are nonspecific. Pulmonary involvement may be widespread or focal and segmental and is accompanied by signs including rales, rhonchi, and decreased breath sounds. Although manifestations of mycoplasma infection are usually confined to the respiratory tract, a wide variety of extrarespiratory manifestations can also occur, including more severe associated diseases such as myocarditis, acute disseminated encephalomyelitis, and cerebral arteriovenous occlusion. The radiographic findings in mycoplasma pneumonia are also nonspecific and in some cases closely resemble those seen in children with viral infections of the lower respiratory tract. Focal reticulonodular opacification confined to a single lobe is a radiographic pattern that seems to be more closely associated with mycoplasma infection than with other types of pediatric respiratory illnesses, and the diagnosis of mycoplasma pneumonia should be considered whenever focal or bilateral reticulonodular opacification is seen. Hazy or ground-glass consolidations frequently occur, but dense homogeneous consolidations like those seen with bacterial pneumonias are uncommon. Atelectasis or transient pseudoconsolidations due to confluent interstitial shadows are often seen. Radiographic findings alone are not sufficient for the definitive diagnosis of mycoplasma pneumonia, but in combination with clinical findings they can significantly improve the accuracy of diagnosis in this disease.