关键词:

Abstract: Objective　To analyze the clinical features of 81 children with Chlamydia pneumoniae pneumonia. Methods　A retrospective analysis was conducted on the medical records of 81 children with Chlamydia pneumoniae pneumonia admitted to the Respiratory Department，Shanghai Children’s Hospital，School of Medicine，Shanghai JiaoTong University between January 2024 and May 2025. Data collected included demographic characteristics，clinical manifestations，laboratory parameters，chest imaging findings，and treatment situation. The clinical features were analyzed. Results　The peak incidence occurred in children aged 6~12 years，accounting for 75.31%（61/81） of cases. Male patients（53 cases，65.43%） outnumbered female patients（28 cases，34.57%）. All patients presented with cough，and pulmonary moist rales and fever were observed in 53.09%（43/81） and 46.91%（38/81） of the patients，respectively. Pulmonary consolidation was the most common imaging finding，presenting in 92.59%（75/81） of cases. Totally 52 children（64.20%） had a hospital stay of ≤5 days，while 35.80%（29/81） were hospitalized for 6~10 days. 77.78%（63/81）of the patients underwent diagnosis and treatment using electronic bronchoscopy. Endobronchitis was the predominant bronchoscopic finding； plastic bronchitis and necrotizing pneumonia were observed in only 7.94%（5/63） and 6.35%（4/63） of cases，respectively. The co-infection rate was 53.09%（43/81）， with bacterial co-infection being the most common（25.93%），primarily involving Streptococcus pneumoniae and Haemophilus influenzae. Viral coinfection accounted for 16.05%，predominantly rhinovirus. Severe pneumonia was identified in 48.15%（39/81）of patients. Compared with the mild group，the severe group had higher CRP levels，a higher proportion of patients undergoing electronic bronchoscopy treatment，and a higher incidence of mixed infection （P<0.001），and there were statistically significant differences. In terms of drug treatment，72.84%（59 cases） of the children used minocycline，and 22.22%（18 cases） used macrolide antibiotics alone. About 9.88%（8 cases） received low-dose methylprednisolone due to bronchoscopic findings suggesting plastic，obstructive，or necrotizing pneumonia. All children were followed up with imaging examinations at 1 week to 1 month after discharge，which showed the lung inflammation was significantly absorbed. Conclusion　Chlamydia pneumoniae pneumonia primarily affects school-aged children，with a higher incidence in males. A high proportion of cases are severe，with elevated CRP levels，and high co-infection rates which are the clinical features worthy of concern. In children aged ≥8 years，novel tetracyclines may represent an effective treatment option，and some children may need to be treated with combined glucocorticoid therapy.

Key words: