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相關文獻
- Extrapulmonary Mycoplasma Pneumoniae Infection
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題名 | Extrapulmonary Mycoplasma Pneumoniae Infection=黴漿菌肺炎的肺外感染 |
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作者姓名(中文) | 林逸甄; 黃立民; 張鑾英; 丘秀慧; 李慶雲; | 書刊名 | 中華民國感染症醫學會雜誌 |
卷期 | 8:1 1997.06[民86.06] |
頁次 | 頁63-71 |
分類號 | 415.463 |
關鍵詞 | 黴漿菌肺炎; 肺外感染; Mycoplasma pneumoniae; Extrapulmonary manifestation; Meningoencephalitis; Hepatitis; Glomerulonephritis; Arthritis; |
語文 | 英文(English) |
中文摘要 | 黴漿菌是人類呼吸道感染的重要病原之一,除了呼吸道疾病外,肺外的表現如神經系統的併發症,肝炎,溶血性貧血,心臟發炎都曾被報告。我們調閱1994年1月至1995年9月間因黴漿菌感染在臺大醫院小兒科治療的病歷來研究黴漿菌感染的肺外表現。診斷的標準是IgM 抗體呈陽性或是補體結合抗體具4倍上升。在193個患童中,有26個(13.4%)具有肺外的症狀。其中8個病兒有神經系統的異常,5個病兒有肝炎,7個病兒有皮疹,2個病兒同時有肝炎及皮疹,1個病兒有關節炎,1個病人有急性腎絲球腎炎。在這9個具有神經系統病變的病人中,有6個 是以急性腦病變或腦炎來表現,有2個人患有無菌性腦膜炎,1個是感染後腦膜炎及多發神經病變。26個病患中有7個(4個腦炎,1個無菌性腦膜炎,1個關節炎,1個肝炎)不具有呼吸道的症狀或是只具有極輕微的呼吸道症狀。除了1個因腦炎死亡外,其餘都能完全復原。因為有的黴漿菌感染只具有非肺部症狀,所以在黴漿菌流行的季節,當我們遇到有上述疾病症狀的病人時,應將黴漿菌感染列入鑑別診斷。 |
英文摘要 | Mycoplasma pneumoniae is one of the most common pathogens infecting the human respiratory tract. Extrapulmonary manifestations of M. pneumoniae infection such as neurological complications, hepatitis, hemolytic anemia, and carditis have been reported. We have retrospectively reviewed all pediatric cases of M. pneumoniae infection treated at National Taiwan University Hospital between Januray 1, 1994 and September 30, 1995. The diagnosis was based on either the presence of IgM antibodies or a fourfold rise in complement fixing antibodies. Among 193 cases, 26 patients (13.4 ﹪) had extrapulmonary manifestations including 8 patients with neurological abnormalities, 5 with hepatitis, 7 with skin rash, 2 with hepatitis and skin rash, 1 with neurological abnormalities and skin rash, 1 with hemolytic anemia and hepatitis, and 1 each with arthritis and acute glomerulonephritis. Of the 9 cases presenting with neurologic changes, 6 had acute encephalopathy or encephalitis, 2 had aseptic meningitis and 1 had post-infectious meningoencephalitis and polyneuropathy. There were 7 patients (27﹪) with minimal or no respiratory symptoms (4 encephalitis, 1 aseptic meningitis, 1 arthritis and 1 hepatitis). All patients recovered completely except 1 fatality from encephalitis. Prominent extrapulmonary manifestations may mask the diagnosis of mycoplasmal infection. Therefore, M. pneumoniae should be considered as a possible etiologic agent in diseased children, especially during the epidemic season. |
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