A decade of pediatric Mycoplasma pneumoniae infections: clinical features, extrapulmonary findings, and predictors associated with advanced care markers abstract

Aims: This study aimed to to describe clinical and radiological characteristics of cold agglutinin-positive pediatric patients and to evaluate factors associated markers of disease severity, including CT utilization, respiratory support and length of hospitalization, in patients with suspected Mycoplasma pneumonia infection and cold agglutination positivity. Methods: A retrospective analysis was conducted on patients aged 0-18 years who presented to the pediatric clinics of Necmettin Erbakan University between January 2015 and January 2025 and had cold agglutinin positivity. Demographics, presenting symptoms, pulmonary and extrapulmonary findings, imaging results, treatment settings, respiratory support needs, and laboratory parameters were extracted from medical records. Comparative analyses between patients with and without chest CT imaging were performed using appropriate statistical tests. Results: A total of 242 patients (52.9% female; mean age 8.31±4.41 years) were included. The most frequent symptoms were cough (83.5%), nonspecific complaints (42.6%), and fever (38.4%). Abnormal respiratory findings were present in 45.0%, most commonly bilateral crackles. Extrapulmonary manifestations occurred in 20.2% of patients. Chest X-rays showed bilateral involvement in 47.9%. Patients who underwent CT imaging had significantly higher rates of abnormal respiratory findings, increased need for supplemental oxygen or noninvasive support, and longer hospital stays (p