Background/Objectives: Mycoplasma pneumoniae (M. pneumoniae), traditionally associated with mild community-acquired pneumonia in school-aged children, has experienced a delayed resurgence following the COVID-19 pandemic. The epidemiological and clinical characteristics of M. pneumoniae pneumonia in children within the context of this global resurgence have not been well established in Romania. Materials and Methods: This retrospective, single-center study analyzed children diagnosed with M. pneumoniae pneumonia who were hospitalized in the pulmonology department of “Grigore Alexandrescu” Emergency Hospital for Children in Bucharest from March to December 2024. Clinical, laboratory, and radiographic data were extracted from hospital records. M. pneumoniae infection was confirmed through polymerase chain reaction (PCR) multiplex panel detection or specific IgM antibody levels ≥ 10 AU/mL. Results: The final analysis included 63 patients who met the inclusion criteria. The cohort’s median age [IQR] was 12.6 [8–15] years, with 11.1% (n = 7) under 6 years old. The radiographic findings revealed a predominance of right lung involvement (52.4%, n = 33, p = 0.03) and a significantly higher prevalence of alveolar infiltrates compared to interstitial patterns (88.9%, n = 56, p < 0.001). Antibiotic choice did not significantly affect hospitalization duration. Pleural effusion emerged as a common complication, occurring in 27% (n = 17) of patients and associated with elevated admission leukocyte counts (p = 0.007). Rare extrapulmonary manifestations included meningoencephalitis (1.6%, n = 1) and reactive infectious mucocutaneous eruption (3.2%, n = 2). Notably, co-infections with other respiratory pathogens did not extend hospital stays. Conclusions: This study contributes to the evolving global epidemiological profile of M. pneumoniae infections in the post-pandemic era. It establishes a foundation for future multi-center analyses aimed at monitoring the changing epidemiology and clinical presentations of M. pneumoniae infections in pediatric populations.

Background/Objectives: Mycoplasma pneumoniae (M pneumoniae), traditionally associated with mild community-acquired pneumonia in school-aged children, has experienced a delayed resurgence following the COVID-19 pandemic. The epidemiological and clinical characteristics of M. pneumoniae pneumonia in children within the context of this global resurgence have not been well-established in Romania. Materials and Methods: This retrospective, single-center study analyzed children diagnosed with M pneumoniae pneumonia who were hospitalized in the Pulmonology Department of "Grigore Alexandrescu" Emergency Hospital for Children in Bucharest from March to December 2024. Clinical, laboratory, and radiographic data were extracted from hospital records. M pneumoniae infection was confirmed through polymerase chain reaction (PCR) multiplex panel detection or specific IgM antibody levels ≥10 AU/mL. Results: The final analysis included 63 patients meeting inclusion criteria. The cohort's median age [IQR] was 12.6 [8-15] years, with 11.1% (n=7) under 6 years old. Radiographic findings revealed a predominance of right lung involvement (52.4%, n=33, p=0.03) and a significantly higher prevalence of alveolar infiltrates compared to interstitial patterns (88.9%, n=56, p< 0.001). Antibiotic choice did not significantly affect hospitalization duration. Pleural effusion emerged as a common complication, occurring in 27% (n=17) of patients and associated with elevated admission leukocyte counts (p=0.007). Rare extrapulmonary manifestations included meningoencephalitis (1.6%, n=1) and reactive infectious mucocutaneous eruption (3.2%, n=2). Notably, co-infections with other respiratory pathogens did not extend hospital stays. Conclusion: This study contributes to the evolving global epidemiological profile of M pneumoniae infections in the post-pandemic era. It establishes a foundation for future multi-center analyses aimed at monitoring the changing epidemiology and clinical presentations of M pneumoniae infections in pediatric populations.

Background and Clinical Significance: Ectopic pancreatic tissue (EPT), an infrequently documented condition within the pediatric population, is often asymptomatic. When clinical manifestations do occur, their severity is contingent upon the location, size, and involvement of the adjacent mucosa. Case presentation: This is a case series study, involving six children aged 15 days–13 years diagnosed with EPT from a single institution. Five of the six cases presented with both EPT and ectopic gastric tissue, located at the site of Meckel’s diverticulum, while one case presented EPT exclusively, which was localized in the duodenum I. A case of Littre’s hernia was identified in a newborn. Two of the six cases experienced gastrointestinal bleeding. Due to limited data on EPT in children, a comprehensive review of the literature was conducted to integrate the findings of the case series. The review synthesized evidence on clinical manifestations, diagnostic approaches, phenotypic classifications, and management strategies. Articles were identified through searches on PubMed and publisher platforms such as Elsevier and Wiley Online Library, using keywords like “ectopic pancreatic tissue”, “heterotopic pancreas”, and “pediatric ectopic pancreas”. Conclusions: The identification of EPT continues to pose a diagnostic challenge, as the symptoms are nonspecific and can sometimes be life-threatening. Additionally, there are currently no specific paraclinical investigations available for this purpose. Histopathological evaluation remains crucial for establishing the diagnosis, which is often confirmed only after complications have arisen.

Background/Objectives: Ectopic pancreatic tissue (EPT), an infrequently documented condition within the pediatric population, is often asymptomatic. When clinical manifestations do occur, their severity is contingent upon the location, size, and involvement of the adjacent mucosa. Methods: This is a case series study, involving children aged 15 days – 13 years diagnosed with EPT from one single institution. Results: Six cases of EPT were identified. Five of the 6 cases presented with both EPT and ectopic gastric tissue, located at the site of Meckel’s diverticulum, while 1 case presented EPT exclusively and it was localized in the duodenum I. A case of Littre’s hernia was identified in a newborn. Two of the 6 cases experienced gastrointestinal bleeding. Conclusions: The identification of EPT continues to pose a diagnostic challenge, as the symptoms are nonspecific and can sometimes be life-threatening. Additionally, there are currently no specific paraclinical investigations available for this purpose.

Pediatric tuberculosis (TB) remains diagnostically challenging because of nonspecific presentations and the frequent absence of microbiological confirmation. We aimed to characterize pediatric TB patients presenting to a non-specialized tertiary hospital in Romania and to explore factors associated with bacteriological confirmation. We retrospectively analyzed children diagnosed with TB between 2017 and 2025 at a tertiary pediatric hospital in Bucharest. Clinical, epidemiological, laboratory, radiological, microbiological, and follow-up data were evaluated. Factors associated with bacteriological confirmation were assessed using univariate and exploratory multivariable analyses. Among 48 patients, the median age was 14 years (IQR 8.25–16), and 37.5% of cases were bacteriologically confirmed. Initial presentations were pleural effusion (47.9%), pneumonia (41.7%), and cavitary disease (10.4%). No patient with pleural effusion had a documented TB contact, compared with 45.0% with pneumonia and 40.0% with cavitary disease (p < 0.001). Bacteriologically confirmed patients were older and more frequently had cavitary lesions. In exploratory Firth penalized logistic regression, older age and the presence of cavitary lesions remained associated with bacteriological confirmation. Pediatric TB may mimic common respiratory diseases even without known TB contact. In exploratory Firth penalized logistic regression, older age and cavitary lesions were associated with bacteriological confirmation, although the estimates, particularly for cavitary lesions, were imprecise and should be interpreted cautiously, while the substantial proportion of clinically diagnosed cases highlights the importance of integrating clinical, radiological, immunological, and microbiological findings.