The most common childhood ailments are infectious and inflammatory diseases of the respiratory tract. The reason for the development of such diseases in a child as rhinitis, sinusitis, otitis media, laryngitis, pharyngitis, in 15% of cases is the bacterium Mycoplasma pneumoniae, a representative of the genus Mycoplasma. If you do not identify the pathogen in time and do not start treatment, the most serious complication of a banal acute respiratory disease can be inflammation of the lung tissue or mycoplasma pneumonia in children.
Causes of occurrence
The causative agents of numerous infectious diseases in children are pathogenic microorganisms – mycoplasmas. There are about 12 types of them. All mycoplasmas have similar features and differ only in the place of dislocation within the body. Damage to the respiratory tract and, as a result, pneumonia is caused by Mycoplasma pneumoniae (M pneumoniae).
Mycoplasma pneumoniae has both bacterial and viral properties. As bacteria, it can grow on nutrient media, respond to antibiotics. Like viruses, they penetrate into the cells of the body and parasitize there.
Features of Mycoplasma pneumoniae and their role in the development of pulmonary diseases in children:
- Size no more than 0.8 microns. The microorganism is transmitted by airborne droplets, quickly sprayed into the external environment when sneezing or coughing. Microscopic size allows easy penetration through the protective environment of the nasal mucosa.
- Instead of a cell wall, mycoplasma is surrounded by a membrane. The microorganism quickly dies outside the human body in the external environment. Therefore, the likelihood of infection is high only with close contact with the carrier. Outbreaks of the disease are often recorded in closed groups of childcare facilities or among family members living together.
- Parasitic lifestyle. Mycoplasmas are able to live and multiply for a long time inside healthy human cells. Disguised in this way, they remain undetected by immune cells and survive after taking antibiotics. Therefore, the disease often proceeds in a latent chronic form and is difficult to treat.
Development mechanism
The microorganism enters the mucous membranes of the child’s nose by airborne droplets. Within a day after infection, mycoplasma attaches to the walls of the ciliated epithelium of the respiratory tract, penetrates into epithelial cells and begins to multiply there.
In the course of its life, M pneumoniae releases toxins that damage mucous membranes, cause inflammation, irritation and, as a result, the primary symptoms of pneumonia. The motor activity of the cilia slows down, which makes it difficult to remove the pathogen from the surface of the mucous membranes. Together with immune cells (phagocytes), M pneumoniae spreads throughout the body.
With rare exceptions, mycoplasma pneumonia differs from other types of pneumonia in a long chronic course. The gradual destruction of epithelial cells by the waste products of M pneumoniae explains the slow increase in clinical symptoms.
Clinical manifestations
Mycoplasma pneumonia is classified as atypical. Its clinical manifestations are somewhat different from those of pneumonia caused by other pathogens.
The incubation period can last from 1 week to 1 month. The rate at which the first symptoms appear depends on the amount of pathogen that has entered the body and the immunity of the sick child.
The onset of the disease is characterized by the following manifestations:
- dryness of the nasal mucous membranes;
- prolonged, dry, unproductive, debilitating cough;
- sore throat;
- subfebrile body temperature;
- weakness, slight malaise;
- great restlessness and crying in infants.
A distinctive feature of mycoplasma pneumonia in children is extrapulmonary symptoms:
- rashes in the form of pink raised spots or papules;
- stomach ache;
- aching joints and muscles.
The following signs indicate pneumonia:
- high temperature up to 39 ° С;
- chest pain that worsens with inhalation or exhalation;
- dyspnea;
- severe coughing fits with scanty sputum.
Diagnostics
The diagnosis of acute respiratory infections is made for every second child admitted to the pediatric department of the polyclinic for treatment. The standard set of therapeutic agents proposed for treatment is not always effective. Sometimes, despite strict adherence to the doctor’s recommendations, the disease progresses. Mycoplasma pneumonia in childhood develops as a result of untimely diagnosis of respiratory mycoplasmosis. Early detection of the pathogen and its differentiation from other types of pneumonia activators play a decisive role in the development of an effective treatment regimen.
An integrated approach to the diagnosis of unspecified pneumonia includes several stages:
- physical examination;
- X-ray examination or computed tomography;
- laboratory diagnostics.
The effectiveness of a physical examination of a patient with suspected pneumonia directly depends on the experience and qualifications of the doctor. When listening to wheezing and noises in the lungs, an X-ray or CT scan is prescribed to clarify the reasons. Due to the lack of clear criteria for the interpretation of the results, the data obtained in the course of instrumental studies do not allow an accurate diagnosis.
The results of a clinical blood test in patients with mycoplasmosis have their own specifics. In the decoding, there is an absence of leukocytosis and a moderate increase in ESR. However, this is also only an indirect sign.
The most reliable diagnostic methods are ELISA and PCR. The essence of the enzyme-linked immunosorbent assay (ELISA) is to detect immune antibodies formed in the blood when they meet with Mycoplasma pneumoniae. The object of the study is the blood serum of a sick child. Various stages of the disease are characterized by the formation of specific antibodies. Thus, using the ELISA method, you can determine how long ago the infection occurred.
An even more accurate way to detect Mycoplasma pneumoniae is the polymerase chain reaction (PCR) method. The method detects the smallest particles of the pathogen DNA in a sample of biological material. For mycoplasmosis, a sputum sample is used for research. PCR diagnostics allows you to identify the causative agent of the disease even during the incubation period.
Treatment methods
It is recommended to treat a child with atypical forms of pneumonia in a hospital setting. First of all, antibiotic therapy is prescribed. The choice of the drug is due to the peculiarities of the structure and vital activity of the pathogen. Given the absence of a cell wall, M pneumoniae has a high degree of resistance to a number of antibiotics: penicillins, cephalosporins.
The standards for the treatment of respiratory mycoplasmosis currently include the following groups of antibacterial drugs:
- macrolides – allowed for use from birth;
- fluoroquinolones – allowed from 5 years old;
- tetracyclines – allowed from 8 years old.
All these drugs are able to penetrate into the cells affected by mycoplasma and, accumulating there, lead to the death of the pathogen. In modern pediatrics, macrolide drugs are most often used, since they have the least number of contraindications. If the child has an individual intolerance, the drug is replaced.
The dosage and duration of antibiotic therapy is determined by the attending physician, taking into account the age of the child, the severity of the course of the disease. In atypical forms of pneumonia, the duration of admission can be from 5 to 14 days.
To facilitate the well-being of a sick child, symptomatic therapy with analgesics, anti-inflammatory, vasoconstrictor, mucolytic, expectorant drugs is also used.
Preventive measures
Mycoplasmosis of the respiratory tract is one of the most common diseases among children under 5 years of age. Seasonal outbreaks of infection in public institutions for children often end in quarantine.
There are no specific measures for the prevention of mycoplasma infection. The vaccine has not yet been completed. To protect yourself and your child from infection, it is recommended to follow simple rules:
- observe personal hygiene;
- wash your hands with soap and water;
- treat the surfaces of furniture items and children’s toys with disinfectant solutions;
- rinse the nose with saline solutions;
- strengthen immunity by hardening, traditional medicine;
- closely monitor the symptoms of acute respiratory infections in a child;
- seek medical help in a timely manner.