Children should be alert to the high incidence of mycoplasma infection in the school season.

　　Recently, mycoplasma infection and mycoplasma pneumonia have become high-frequency words in mom circle. Three years after the epidemic in COVID-19, before the arrival of mycoplasma infection, children have experienced several rounds of infectious diseases, which are influenza, syncytial virus infection, infectious diarrhea, herpetic angina and so on. From the beginning of school in March this year to the present, "one disease per month" children account for a considerable proportion.

　　The epidemic time of mycoplasma was advanced, and it spread widely.

　　During the epidemic in COVID-19, because everyone wears masks, washes hands frequently, keeps social distance, increases ventilation and disinfects more surfaces, children’s contact with other pathogens is reduced, and the incidence of virus and bacterial infections is reduced. However, everything has two sides. The decrease of infection makes the immune stimulation of pathogens insufficient, the susceptible population increases and the group immunity decreases. After reducing the intensity and scale of group protection in many countries, the incidence of respiratory syncytial virus and other pathogens increased significantly. In this context, experts put forward the concept of immune debt during COVID-19 (the above content was quoted from the No.1 issue of journal of applied clinical pediatrics Journal of China, Volume 38, January 2023, "Immune debt and its influence during the epidemic of children in novel coronavirus").

　　To put it simply, COVID-19’s three-year-old children may get one disease at a time. The flu hit first, and now it’s mycoplasma’s turn.

　　Mycoplasma is a prokaryotic microorganism similar to bacteria but without cell wall, which is between bacteria and viruses, smaller than bacteria and larger than viruses, and is the main pathogenic microorganism of respiratory tract infection. Most common mycoplasma epidemics occur in November and December every year, and this year is advanced to August and September, which affects a wider range of people. The children’s condition is biased and the course of disease is long.

　　Mycoplasma pneumonia has typical characteristics, and children should be vigilant in the following situations.

　　1. Severe irritating dry cough: Severe cough is a prominent symptom of this disease. At the beginning, it is a dry cough, and the cough is stubborn and severe. The child can’t stop coughing and even affect the activities during the day and sleep at night. Late sputum, cough is still severe.

　　2. Fever: high fever is common. If not treated, the fever will persist. There are also people with low body temperature or even no fever, which are relatively few.

　　3. Auscultation often does not hear rales: general doctors with lung infections can hear wet rales, but most of mycoplasma pneumonia can’t hear rales. The auscultation of the lung is very inconsistent with the clinical manifestations such as severe cough and high fever, which has become one of the characteristics of this disease. Therefore, the diagnosis of mycoplasma pneumonia often needs chest radiography to assist the diagnosis.

　　4. Chest X-ray: Typical mycoplasma pneumonia often shows large shadows in the lungs.

　　5. Routine blood test: Routine blood test of mycoplasma has no characteristics, unlike typical bacterial infection, where the total number of white blood cells, neutrophils and CRP are all increased, and unlike virus infection, which is basically normal, white blood cells are often normal or high, or one of them is high.

　　6. Mycoplasma pneumoniae antibody test: Mycoplasma antibody test positive can help diagnosis, but negative can not be excluded. And mycoplasma antibodies are often not detected at the early stage of the disease, which is not helpful for early diagnosis.

　　These are the characteristics of typical mycoplasma pneumonia, but actually not all mycoplasma pneumonia show these characteristics. Clinically, some children only have a high fever and their cough is not obvious. In the clinic, I once met a child who had a fever for 5 days, accompanied by a mild cough for 2 days, and a film was also pneumonia. Some children have no obvious fever, only moderate to low fever, and even have no fever but cough is very severe, and filming is also pneumonia.

　　About mycoplasma infection, these problems should be clear.

　　Will children get pneumonia if they are infected with mycoplasma? Mycoplasma pneumonia is very difficult, okay? Will there be sequelae? Parents have too many questions to answer.

　　First of all, it should be noted that infection with mycoplasma (mycoplasma pneumoniae) does not necessarily lead to pneumonia. Mycoplasma (mycoplasma pneumoniae) can not only cause pneumonia, but also cause upper respiratory tract infection (common cold symptoms) and tracheitis.

　　Which children are susceptible to mycoplasma (mycoplasma pneumoniae) infection? Mycoplasma pneumoniae mainly infects children aged 5-9, that is, school-age children. Recently, this wave of mycoplasma infection has spread to a wider age group, and infants also have severe mycoplasma pneumonia.

　　How to treat mycoplasma pneumonia? Once mycoplasma pneumonia is diagnosed, macrolide drugs such as erythromycin and azithromycin are given for treatment. Mycoplasma infection is not sensitive to penicillins and cephalosporins.

　　Why do children still progress to pneumonia after taking azithromycin? Is it delayed? Azithromycin is a specific drug for treating mycoplasma infection. Some children took azithromycin orally in the early stage of fever, but their condition was still getting worse and more serious pneumonia appeared. Parents often don’t quite understand why they developed pneumonia after taking azithromycin at the early stage of taking their children to see a doctor. The reason for this is complicated, which may be related to the variation or drug resistance of mycoplasma. It may also be related to the child’s poor rest after illness, or to the child’s physique.

　　Mycoplasma pneumonia is very difficult, okay? Will there be sequelae? Mycoplasma pneumonia has a good prognosis after regular treatment. However, there are also serious mycoplasma pneumonia, and the effect of antibiotic treatment is not ideal, so special drugs such as hormones are needed, and some need bronchoscopy to assist diagnosis and treatment.

　　If mycoplasma pneumonia is diagnosed, the child should be treated completely according to the doctor’s requirements, and hospitalization is needed if necessary. Have a good rest during and after the treatment, and don’t take classes with illness. After the treatment, you need a rest period.

　　How to prevent mycoplasma pneumonia? When the child is at school, the class should actively open the window for ventilation; Children should carry out appropriate physical activities to increase immunity; Don’t arrange extracurricular classes and physical classes too full, but step by step, so that children can have an adaptation process; Drink plenty of water, don’t eat too much, and ensure daily defecation. Daily ventilation should be ensured in the family. If children have mycoplasma infection, isolation should be implemented as much as possible to reduce cross-infection in the family.