Disseminated cryptococcosis is a rare and fatal disease, and limited data exist regarding it in children. This study aimed to investigate the clinical characteristics of disseminated cryptococcosis in previously healthy children in China. Hospitalized patients with disseminated cryptococcosis were enrolled during January 1996 to December 2015 in Beijing Children’s Hospital, Capital Medical University, China. Data on clinical manifestations, laboratory tests, treatment, and prognosis were evaluated. A total of 52 pediatric patients with no underlying disease were enrolled, including 38 boys and 14 girls. Only 10 cases had a history of exposure to pigeon droppings. Fever, cough, and hepatomegaly were 3 main manifestations of disseminated cryptococcosis. However, headache was more common in patients with central nervous system (CNS) invasion than in patients with non-CNS invasion (P < 0.05). Lung (96.2%, 50/52) was the most commonly invaded organ, but only 9.6% (5/52) of patients had respiratory signs. The most common findings on chest imaging were hilar or mediastinal lymphadenopathy (46.8%, 22/47), and nodules (44.7%, 21/47), including small nodules in a scattered distribution (57.1%, 12/21) or miliary distribution (42.9%, 9/25), especially localized in subpleural area. Subsequent invasion occurred in the CNS, abdomen lymph nodes, liver, spleen, peripheral lymph nodes, and skin. In all patients, 42.3% (22/52) and 51.9% (27/52) had elevated eosinophils or IgE, respectively. The positive rate of serum cryptococcal antigen was higher, especially in patients with CNS invasion (approximately 83.3%), than with other primary methods used for pathogen detection, including cerebrospinal fluid (CSF) cryptococcal antigen, cultures of blood, bone marrow, or CSF, and CSF ink staining. The overall mortality rate of pediatric patients in our study was 11.5% (6/52). Some cases had long-term sequela, including hydrocephalus, cirrhosis, or blindness. Disseminated cryptococcosis can occur in previously healthy or immunocompetent children in China. Lung and CNS were most commonly invaded by this disease. Furthermore, most cases usually showed no obvious or specific symptoms or signs, and therefore pediatricians should pay more careful attention to identify this disease.

Mycoplasma pneumoniae pneumonia (MPP) is a leading cause of community-acquired pneumonia in children. The COVID-19 pandemic substantially disrupted the transmission dynamics of M. pneumoniae, yet large-scale, nationwide data characterizing the clinical and epidemiological evolution of pediatric MPP in China across the pandemic period remain scarce. We analyzed 325,781 MPP hospitalizations from 31 tertiary children's hospitals across mainland China between 2016 and 2023, using the FUTURE Database. Temporal trends and demographic differences in disease severity, co-infections, complications, length of stay (LOS), and hospitalization costs were systematically evaluated. MPP admissions peaked in 2023, accounting for 8.76% of all pediatric hospitalizations. The male-to-female ratio was 1.15:1. children aged 3-6 years accounted for the largest proportion (32.42%), though children aged 6-10 years became predominant in 2023. Severe MPP increased significantly over time (P for trend <0.0001), rising from 3.78% in 2017 to above 13% after 2020. Viral and bacterial co-infection rates rose significantly to 24.13% and 10.09% in 2023, with infants bearing the highest burden. Respiratory complications increased over time to over 10% after 2021, while extrapulmonary complications declined. The median LOS was 7 days (IQR 5-9), and the median cost was 5891.61CNY (IQR 4427.86-8425.95), both decreased significantly from 2016 to 2023. Severe MPP and coinfections were associated with longer LOS and higher costs. This nationwide multicenter study reveals a post-pandemic surge in pediatric MPP in China, with rising severity, a shift towards school-aged children, and increasing co-infection rates. Despite improved healthcare efficiency, growing clinical complexity demands enhanced surveillance, risk stratification, and public health preparedness.

Thrombocytopenia is a frequently overlooked yet clinically relevant manifestation of Epstein-Barr virus (EBV) infection, particularly in children. Although it is commonly associated with EBV-related conditions, thrombocytopenia is often misdiagnosed as primary immune thrombocytopenia or dismissed as an incidental finding. This review summarizes current evidence linking EBV infection and thrombocytopenia, highlighting its potential as an early clinical clue. We emphasize the importance of timely EBV testing in pediatric patients with unexplained thrombocytopenia and advocate for greater clinical awareness and multidisciplinary research. Recognizing thrombocytopenia as more than a minor laboratory abnormality may improve diagnostic accuracy, guide appropriate treatment, and inform future research directions.

Background/Objectives: Chlamydia trachomatis (C. trachomatis) is an important cause of community-acquired pneumonia in early infancy; however, its subtle and nonspecific clinical features often result in underdiagnosis and delayed treatment. Evidence regarding clinical predictors of severe disease and distinctive imaging manifestations remains limited. This study aimed to characterize the clinical and imaging features of hospitalized infantile C. trachomatis pneumonia and to identify potential indicators associated with disease severity. Methods: This retrospective study enrolled infants with confirmed C. trachomatis pneumonia hospitalized at Beijing Children’s Hospital from January 2016 to December 2025. Data on demographics, clinical presentations, laboratory findings, chest imaging, treatments, and outcomes were systematically collected. Exploratory subgroup analyses were performed to compare severe and non-severe cases and identify severity-associated factors. Results: A total of 30 infants (16 boys, 14 girls) were included, with a median age of 34.0 days (IQR, 23.5–39.8 days) at symptom onset. Cough was nearly universal (96.7%), while fever, tachypnea, and wheezing were observed in 43.3%, 43.3%, and 40.0%, respectively. Pulmonary crackles were present in 86.7%, and eosinophilia in 40.0%. Cytomegalovirus co-infection occurred in 36.7%. Chest CT revealed patchy opacities (100%), interstitial changes (86.7%), mass-like/nodular opacities (63.3%), and diffuse miliary/granular opacities (13.3%). Among 14 patients undergoing bronchoscopy, 50.0% had thick airway secretions. Tachypnea and retractions emerged as important clinical indicators of severe disease. All patients recovered with macrolide therapy, and no deaths occurred. Conclusions: Infantile C. trachomatis pneumonia typically presents with absent or low-to-moderate fever, paroxysmal cough, and occasional wheezing. Tachypnea and retractions may serve as early indicators of severe disease. Atypical chest imaging patterns, including mass-like and miliary opacities, provide valuable diagnostic clues. Once the diagnosis is established, prompt initiation of macrolide therapy is recommended, and the overall prognosis is favorable.