Objective To explore the correlation between chest CT findings and C-reactive protein (CRP) levels in children with Mycoplasma pneumoniae pneumonia (MPP). Methods A retrospective analysis was conducted on the clinical data of 103 children with MPP admitted to the Department of Pediatrics of Nanning Red Cross Hospital from January 2015 to August 2024. According to the CRP level, the children were divided into four groups: Group A (<10 mg/L), Group B (10-<20 mg/L), Group C (20-<30 mg/L), and Group D (≥30 mg/L). Cochran-Armitage trend test was used to analyze the association between serum CRP levels and the abnormal rate of chest CT findings, the rates of unilateral and bilateral multi-lobe involvement, and the detection rate of various CT abnormal signs. Results The results of Cochran-Armitage trend test showed that with the increase of serum CRP level, the abnormal rate of chest CT findings, the involvement rate of multiple lobes in unilateral lung, the involvement rate of multiple lobes in bilateral lungs, and the detection rates of bronchial wall thickening, ground-glass opacity, small patchy opacity, large patchy or segmental consolidation, and pleural effusion or atelectasis in children with MPP all showed an upward trend (all P<0.05). Conclusion The serum CRP level of children with MPP is positively correlated with the severity of chest CT findings. An increase in serum CRP level indicates an expansion of the scope of pulmonary imaging lesions and an aggravation of signs. Serum CRP level ≥20 mg/L may be a potential cut-off value for predicting significant pulmonary imaging abnormalities in children with MPP.

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