Diagnosing Mycoplasma pneumoniae in children and adolescents with community-acquired pneumonia.

摘要

REVIEW QUESTION: What is the diagnostic accuracy of signs and symptoms in the clinical recognition of Mycoplasma pneumoniae as the cause of community-acquired pneumonia in children and adolescents?TYPE OF REVIEW: This is a Cochrane diagnostic test accuracy systematic review containing meta-analyses of data from seven studies. RELEVANCE FOR NURSING: Up to 40% of children over five years of age who develop community-acquired pneumonia are infected by M. pneumoniae. Currently, there is no universally agreed-upon gold standard laboratory test for M. pneumoniae, which is typically treated with macrolide antibiotics. Serology, the most widely available test, can require both acute and convalescent serum samples, taken two to four weeks apart. Because of the lack of a quick, reliable method for diagnosing suspected M. pneumoniae infections, clinicians mostly rely on clinical signs and symptoms. These include cough, wheeze, nasal symptoms, crepi-tations(crackles heard during chest examination), fever, rhonchi (wheeze heard during chest examination), shortness of breath, chest pain, diarrhea, myalgia, and headache. The purpose of this review was to assess the value of each of these 11 signs and symptoms in diagnosing M. pneumoniae in children and adolescents with community-acquired pneumonia.