J Clin Med Res

Journal of Clinical Medicine Research, ISSN 1918-3003 print, 1918-3011 online, Open Access

Article copyright, the authors; Journal compilation copyright, J Clin Med Res and Elmer Press Inc

Journal website http://www.jocmr.org

Original Article

Volume 10, Number 12, December 2018, pages 891-897

Mycoplasma Pneumoniae Pneumonia: Walking Pneumonia Can Cripple the Susceptible

**Table 1.** Patient Demographic Characteristics and Comorbid Conditions
	Survivors N = 187 (%)	Non-survivors N = 16 (%)	P value
Age, year (mean ± SD)	53 ± 18	65 ± 21	T = 2.526; P = 0.012
Male sex	86 (46)	7 (44)	1.000
Race/ethnicity
Black	91 (48.6)	8 (50)	1.000
Hispanic	92 (49.2)	8 (50)	1.000
Others	4 (2.2)	0	1.000
Current smoker	91 (48.6)	7 (43.8)	0.798
Obstructive airway disease	108 (57.8)	3 (18.8)	0.003
Human immunodeficiency virus infection	46 (24.6)	2 (12.5)	0.368
Liver disease	46 (24.6)	4 (25)	1.000
Malignancy	15 (8)	2 (12.5)	0.629
Diabetes mellitus	40 (21.4)	6 (37.5)	0.208

Table 1. Patient Demographic Characteristics and Comorbid Conditions

Survivors
N = 187 (%)

Non-survivors
N = 16 (%)

P value

Age, year (mean ± SD)

53 ± 18

65 ± 21

T = 2.526; P = 0.012

Male sex

86 (46)

7 (44)

1.000

Race/ethnicity

Black

91 (48.6)

8 (50)

1.000

Hispanic

92 (49.2)

8 (50)

1.000

Others

4 (2.2)

1.000

Current smoker

91 (48.6)

7 (43.8)

0.798

Obstructive airway disease

108 (57.8)

3 (18.8)

0.003

Human immunodeficiency virus infection

46 (24.6)

2 (12.5)

0.368

Liver disease

46 (24.6)

4 (25)

1.000

Malignancy

15 (8)

2 (12.5)

0.629

Diabetes mellitus

40 (21.4)

6 (37.5)

0.208

**Table 2.** Symptoms and Extrapulmonary Involvement of Patients With MPP
Symptom(s)	Survivors N = 187 (%)	Non-survivors N = 16 (%)	P value
Chest pain	23 (12.3)	0	0.23
Dyspnea	126 (67.3)	8 (50)	0.17
Cough	133 (71.1)	5 (31.2)	0.003
Gastrointestinal	35 (18.7)	4 (25)	0.51
Headache	25 (13.3)	6 (37.5)	0.02
Weight loss	6 (3.2)	0	1.00
Fever	100 (53.4)	10 (62.5)	0.60
Musculoskeletal	2 (1)	3 (18.7)	0.003
Exacerbation of obstructive airway disease (OAD)	39 (20.8)	1 (6.2)	0.204
Patients given systemic steroids for OAD	39 (20.8)	1 (6.2)	0.204
Extrapulmonary involvement of MP
Renal	81 (43.3)	15 (93.8)	0.0001
Gastrointestinal	169 (90.4)	16 (100)	0.0001
Cardiovascular	39 (20.8)	11 (68.8)	0.0001
Hematological	29 (15.5)	3 (18.8)	0.72
Musculoskeletal	106 (56.7)	16 (100)	0.0003
Pulmonary involvement	150 (80.2)	16 (100)	0.047

Table 2. Symptoms and Extrapulmonary Involvement of Patients With MPP

Symptom(s)

Survivors
N = 187 (%)

Non-survivors
N = 16 (%)

P value

Chest pain

23 (12.3)

0.23

Dyspnea

126 (67.3)

8 (50)

0.17

Cough

133 (71.1)

5 (31.2)

0.003

Gastrointestinal

35 (18.7)

4 (25)

0.51

Headache

25 (13.3)

6 (37.5)

0.02

Weight loss

6 (3.2)

1.00

Fever

100 (53.4)

10 (62.5)

0.60

Musculoskeletal

2 (1)

3 (18.7)

0.003

Exacerbation of obstructive airway disease (OAD)

39 (20.8)

1 (6.2)

0.204

Patients given systemic steroids for OAD

39 (20.8)

1 (6.2)

0.204

Extrapulmonary involvement of MP

Renal

81 (43.3)

15 (93.8)

0.0001

Gastrointestinal

169 (90.4)

16 (100)

0.0001

Cardiovascular

39 (20.8)

11 (68.8)

0.0001

Hematological

29 (15.5)

3 (18.8)

0.72

Musculoskeletal

106 (56.7)

16 (100)

0.0003

Pulmonary involvement

150 (80.2)

16 (100)

0.047

**Table 3.** Laboratory Parameters
Laboratory parameters Mean ± SD (n) (units)	Survivors N = 187	Non-survivors N = 16	P value
Serum lactic dehydrogenase (unit/L)	346 ± 227 (N = 81)	2,113 ± 1,476 (N = 4)	T = 9.627; P = 0.0001
Serum haptoglobin (mg/dL)	169 ± 126 (N = 29)	132 ± 120 (N = 3)	T = 0.486; P = 0.631
Serum creatinine kinase (unit/L)	558 ± 1,645 (N = 106)	1,029 ± 2,780 (N = 16)	T = 0.962; P = 0.338
Serum blood urea nitrogen	25 ± 20	54 ± 40	T = 5.032; P = 0.0001
Serum creatinine (mg/dL)	1.3 ± 1.0	3.3 ± 3	T = 6.076; P = 0.0001
White blood cells (k/µL)	13.7 ± 7.0	22.7 ± 9.1	T = 4.814; P = 0.0001
Platelets (k/µL)	269 ± 134	241 ± 126	T = 0.806; P = 0.421
Serum aspartate transaminase (unit/L)	84 ± 260 (N = 169)	1,789 ± 305 (N = 16)	T = 7.179; P = 0.0001
Serum alkaline transaminase (unit/L)	59 ± 203 (N = 169)	566 ± 936 (N = 16)	T = 5.853; P = 0.0001
Troponin T (ng/mL)	1.0 ± 0.3 (N = 39)	0.45 ± 0.64 (N = 11)	T = 2.591; P = 0.013
Mycoplasma IgM titers (U/mL)	1,555 ± 1,127	1,366 ± 582	T = 0.662; P = 0.509

Table 3. Laboratory Parameters

Laboratory parameters
Mean ± SD (n) (units)

Survivors
N = 187

Non-survivors
N = 16

P value

Serum lactic dehydrogenase (unit/L)

346 ± 227 (N = 81)

2,113 ± 1,476 (N = 4)

T = 9.627; P = 0.0001

Serum haptoglobin (mg/dL)

169 ± 126 (N = 29)

132 ± 120 (N = 3)

T = 0.486; P = 0.631

Serum creatinine kinase (unit/L)

558 ± 1,645 (N = 106)

1,029 ± 2,780 (N = 16)

T = 0.962; P = 0.338

Serum blood urea nitrogen

25 ± 20

54 ± 40

T = 5.032; P = 0.0001

Serum creatinine (mg/dL)

1.3 ± 1.0

3.3 ± 3

T = 6.076; P = 0.0001

White blood cells (k/µL)

13.7 ± 7.0

22.7 ± 9.1

T = 4.814; P = 0.0001

Platelets (k/µL)

269 ± 134

241 ± 126

T = 0.806; P = 0.421

Serum aspartate transaminase (unit/L)

84 ± 260 (N = 169)

1,789 ± 305 (N = 16)

T = 7.179; P = 0.0001

Serum alkaline transaminase (unit/L)

59 ± 203 (N = 169)

566 ± 936 (N = 16)

T = 5.853; P = 0.0001

Troponin T (ng/mL)

1.0 ± 0.3 (N = 39)

0.45 ± 0.64 (N = 11)

T = 2.591; P = 0.013

Mycoplasma IgM titers (U/mL)

1,555 ± 1,127

1,366 ± 582

T = 0.662; P = 0.509

**Table 4.** Comparison of Chest Imaging Results
Chest X-ray (CXR) on admission	Survivors N = 187 (%)	Non-survivors N = 16 (%)	P value
CXR-unilateral infiltrates	93 (50%)	6 (37.5)	0.438
CXR-bilateral infiltrates	57 (30.5)	10 (62.5)	0.0128
CXR-normal	37 (19.8)	0	0.047
Chest computed tomography (CT) scan on admission
Number of patients with chest CT scan	64 (34.2)	3 (18.7)	0.27
Ground-glass opacification/airspace consolidation	22 (34.4)	1 (33.3)	1.000
Nodules/masses	8 (12.5)	1 (33.3)	0.355
Bronchovascular thickening/linear opacities	13 (6.9)	0	1.000
Pleural effusion(s)	15 (23.4)	0	1.000
Lymphadenopathy	4 (6.3)	0	1.000
Bronchiectasis	7 (10.9)	0	1.000
Cavitary lesions	2 (3)	0	1.000
Acute pulmonary embolism	1 (1.5)	1 (33.3)	0.08
Normal CXR with abnormal chest CT	8 (12.5)	0	1.000

Table 4. Comparison of Chest Imaging Results

Chest X-ray (CXR) on admission

Survivors
N = 187 (%)

Non-survivors
N = 16 (%)

P value

CXR-unilateral infiltrates

93 (50%)

6 (37.5)

0.438

CXR-bilateral infiltrates

57 (30.5)

10 (62.5)

0.0128

CXR-normal

37 (19.8)

0.047

Chest computed tomography (CT) scan on admission

Number of patients with chest CT scan

64 (34.2)

3 (18.7)

0.27

Ground-glass opacification/airspace consolidation

22 (34.4)

1 (33.3)

1.000

Nodules/masses

8 (12.5)

1 (33.3)

0.355

Bronchovascular thickening/linear opacities

13 (6.9)

1.000

Pleural effusion(s)

15 (23.4)

1.000

Lymphadenopathy

4 (6.3)

1.000

Bronchiectasis

7 (10.9)

1.000

Cavitary lesions

2 (3)

1.000

Acute pulmonary embolism

1 (1.5)

1 (33.3)

0.08

Normal CXR with abnormal chest CT

8 (12.5)

1.000

**Table 5.** Comparison of Antibiotic Management
Treatment characteristics	Survivors N = 187 (%)	Non-survivors N = 16 (%)	P value
Macrolides	124 (66.3)	3 (18.8)	0.0003
Quinolones	14 (7.5)	1 (6.2)	1.000
Both: macrolides and quinolones	16 (8.5)	2 (12.5)	0.639
Either	138 (73.8)	6 (37.5)	0.007
No antibiotics to cover for mycoplasma	33 (17.6)	10 (62.5)	0.0002
Appropriate antibiotic	154 (82.3)	6 (37.5)	0.0002
Appropriate antibiotics after 24 h	14 (7.5)	1 (6.2)	1.000
Days of appropriate antibiotic	5.82 ± 3.45 (N = 154)	6.33 ± 5.47 (N = 6)	T = 0.347; P = 0.729

Table 5. Comparison of Antibiotic Management

Treatment characteristics

Survivors
N = 187 (%)

Non-survivors
N = 16 (%)

P value

Macrolides

124 (66.3)

3 (18.8)

0.0003

Quinolones

14 (7.5)

1 (6.2)

1.000

Both: macrolides and quinolones

16 (8.5)

2 (12.5)

0.639

Either

138 (73.8)

6 (37.5)

0.007

No antibiotics to cover for mycoplasma

33 (17.6)

10 (62.5)

0.0002

Appropriate antibiotic

154 (82.3)

6 (37.5)

0.0002

Appropriate antibiotics after 24 h

14 (7.5)

1 (6.2)

1.000

Days of appropriate antibiotic

5.82 ± 3.45 (N = 154)

6.33 ± 5.47 (N = 6)

T = 0.347; P = 0.729

**Table 6.** Comparison of Outcomes Between Survivors and Non-Survivors
Outcomes	Survivors N = 187 (%)	Non-survivors N = 16 (%)	P value
Intensive care unit (ICU) admission	68 (36.3)	12 (75)	0.003
Septic shock	13 (6.9)	5 (31.2)	0.007
Mechanical ventilation	16 (8.5)	11 (68.8)	0.0001
ICU length of stay (days)	5.6 ± 10	6.0 ± 8.2	T = 0.155; P = 0.877
Hospital length of stay (days)	7.3 ± 8.0	9.4 ± 10	T = 0.987; P = 0.325

Table 6. Comparison of Outcomes Between Survivors and Non-Survivors

Outcomes

Survivors
N = 187 (%)

Non-survivors
N = 16 (%)

P value

Intensive care unit (ICU) admission

68 (36.3)

12 (75)

0.003

Septic shock

13 (6.9)

5 (31.2)

0.007

Mechanical ventilation

16 (8.5)

11 (68.8)

0.0001

ICU length of stay (days)

5.6 ± 10

6.0 ± 8.2

T = 0.155; P = 0.877

Hospital length of stay (days)

7.3 ± 8.0

9.4 ± 10

T = 0.987; P = 0.325