Association of Mycoplasma Pneumoniae Infections with Status Asthmaticus

Viral respiratory infections (VRI) have been commonly associated with exacerbation of wheezing in asthmatic children. Mycoplasma pneumoniae (MP) causes many respiratory syndromes that clinically mimic VRI. Due to the nature of the organism, cultures are of no practical value and the diagnosis is usually made by serology. Only a few studies have associated mycoplasma infections with acute exacerbations of wheezing in the asthmatic patient. This study was an attempt to assess the incidence of recent mycoplasma infections in patients with status asthmaticus and to review their laboratory, clinical and radiological findings.

Retrospective review of all patients admitted to PICU over 12 month period with status asthmaticus. Recent mycoplasma infection was determined utilizing the Immunocard Mycoplasma Enzyme Immunoassay (EIA) for detection of MP IgM antibodies (Meredian Diagnostics, Inc., Cincinnati, OH)

The records of 44 patients were reviewed. 9 were excluded because MP tests were never obtained during hospitalization. 15/35 (42%) were MP Positive. There were no statistically significant differences (P>0.05) in length of hospitalization (LOH), ICU days, duration of continuous albuterol aerosol hours (cont. Nebs hrs.), days on O2 (02 days) or WBC between the two groups, however patients who were mycoplasma positive were treated with a macrolide antibiotic in addition to their standard asthma therapy. Patients with evidence of recent MP infection were more likely to have one or more infiltrates on their CXR (13/15 vs 7/20; P= 0.002).

Our study suggests that recent MP infections play a significant role in exacerbations of asthma and occurrence of status asthmaticus in children. The presence of infiltrates on CXR in status asthmaticus warrants tests for MP.