Abstract:

Objective To analyze the clinical characteristics of pediatric Chlamydia pneumoniae pneumonia (CPP) and explore the correlation between chest CT imaging classification and prognosis. Methods A retrospective analysis was conducted on clinical data from 76 children with CPP admitted between March 2024 and January 2026. Patients were classified into four CT patterns according to chest imaging features. Clinical manifestations, bronchoscopic results, and outcomes were compared among groups. Results Among the 76 cases, there were 43 boys and 33 girls, with a mean age at presentation of 12.2 ± 2.75 years. The main symptoms were cough (76/76, 100%) and fever (39/76, 51.3%), with a mean febrile duration of 3.59 days and median body temperature of 38.3 ℃; systemic infection signs were mild. Mean hospital stay was 9.78 ± 4.84 days. Pathogen detection was achieved by targeted next-generation sequencing of bronchoalveolar lavage fluid in 61 cases (80.2%) and by throat swab PCR in 15 cases (19.7%). Bronchoscopy revealed mucosal erosion, necrosis or hemorrhage in 43 cases (56.6%), ventilation impairment in 27 cases (35.5%), and distal subsegmental occlusion in 3 cases (3.9%). Lesion resolution rates differed significantly among types: large consolidation without air bronchogram had the lowest resolution rate (48.3%), which was significantly lower than that of the mass-like type (94.1%) and the large consolidation with air bronchogram type (88.5%)， χ²=16.22, P<0.001. Conclusion Chest radiographic findings in pediatric CPP play a crucial role in guiding therapeutic strategies and predicting clinical outcomes. The "large consolidation without air bronchogram" pattern is significantly associated with poor lesion resolution, indicating the need for individualized treatment strategies and closer follow-up in affected patients.

Key words: Chlamydia pneumoniae pneumonia, clinical features, imaging-based classification, bronchoscopy, child