Combined Diagnostic Approach for Refractory Mycoplasma Pneumonia in Children

Inclusion Criteria: * Aged 1-12 years. * Diagnosed with Mycoplasma pneumoniae pneumonia (MPP) based on clinical symptoms (persistent cough, fever ≥38.5°C for ≥5 days), positive serological tests (IgM antibodies ≥1:160), and chest imaging findings (consolidation or ground-glass opacity). * Defined as refractory MPP, with no improvement or worsening of symptoms (e.g., fever duration \>7 days, increasing respiratory distress) after ≥7 days of standard macrolide therapy. Exclusion Criteria: * Presence of severe comorbidities (e.g., congenital heart disease, primary immunodeficiency, chronic lung disease). * Confirmed bacterial or viral coinfection. * Known allergies to macrolides or sedatives used for bronchoscopy. * Guardians refused to provide informed consent. * Deemed unfit for bronchoscopy (e.g., unstable hemodynamics).