Methods: : We evaluated the clinical effects of steroid pulse therapy retrospectively in 12 children with severe refractory M. pneumoniae pneumonia, diagnosed serologically. All of the patients, who showed the respiratory distress, high fever and initial lobar pneumonic consolidation with pleural effusion radiologically, and deteriorated despite of antibiotic therapy were treated with intravenous methylprednisolone pulse therapy in addition to antibiotics.
Results: The average febrile period prior to admission was 4.9±1.7 days and that was 3.7±1.6 days after using antibiotics. We initiated methylprednisolone pulse therapy at a dose of 30mg/kg on the day 5.4±2.5 of admission. After pulse therapy, the clinical symptoms and signs were improved in all patients without adverse events of steroid therapy. In particular, the high fever was subsided within 0-2 hours after initiation of steroid pulse therapy. The abnormal radiologic findings were resolved on the days 2.6±1.3 and the high levels of C-reactive protein (6.7±5.9mg/dl on admission) was decreased to 1.3±1.7mg/dl on the days 3.0±1.1 of steroid therapy.
Conclusions: This study showed an impact of 3-day methylprednisolone pulse therapy on severe refractory M. pneumoniae pneumonia in children despite appropriate antibiotic therapy. The steroid pulse therapy is apparently an efficacious and well-tolerated treatment for severe refractory M. pneumoniae pneumonia.