Objective:

To explore the clinical characteristics and factors associated with cerebral infarction (CI) in pediatric patients with Mycoplasma pneumoniae pneumonia (MPP), highlighting the importance of early recognition and management.

Key Findings:

• Among 2,947 children with MPP, 9 (0.3%) developed CI. Higher levels of CRP and D-dimer were significantly associated with CI (CRP: OR = 1.08, p = 0.003; D-dimer: OR = 1.00026, p = 0.007), indicating a potential biomarker role. The combination of CRP and D-dimer showed good discriminatory performance for CI with an AUC of 0.920 (p < 0.001).

Interpretation:

Elevated CRP and D-dimer levels may serve as biomarkers for assessing the risk of CI in children with MPP, indicating a potential link between inflammation and coagulation that could inform clinical decision-making.

Limitations:

• The study is retrospective and may be subject to biases, including selection bias. The small sample size of CI cases limits generalizability and the ability to draw definitive conclusions.

Conclusion:

Elevated CRP and D-dimer levels are associated with CI in children with MPP, suggesting their potential role in risk stratification. Further multicenter studies with larger sample sizes are needed for validation and to clarify their clinical utility.