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儿童社区获得性肺炎

Childhood community-acquired pneumonia.

作者信息

Ruuskanen O, Mertsola J

机构信息

Department of Pediatrics, Turku University Hospital, Finland.

出版信息

Semin Respir Infect. 1999 Jun;14(2):163-72.

Abstract

Much of what we know about childhood community-acquired pneumonia in developed countries comes from studies in Europe, where approximately 2.5 million cases of childhood pneumonia occur yearly. Streptococcus pneumoniae, Mycoplasma pneumoniae, and respiratory syncytial virus are the most common causative agents. Blood culture is seldom positive and mortality is very low in developed countries. Tachypnea and crackles on auscultation are the major findings suggesting pneumonia, but their sensitivity and specificity are not high enough, and, if possible, a radiograph of the chest should be obtained to confirm the diagnosis. Recommendations for antibiotic treatment vary. Based on the etiologic studies we suggest macrolides as the first choice in outpatients and depending on the clinical picture and severity of the illness penicillin G, macrolide, or cefuroxime plus macrolide in hospitalized patients. The recovery of children with pneumonia is usually rapid and in uncomplicated cases routine follow-up radiographs and check-ups are unnecessary.

摘要

我们对发达国家儿童社区获得性肺炎的许多了解都来自欧洲的研究,在欧洲,每年约有250万例儿童肺炎病例。肺炎链球菌、肺炎支原体和呼吸道合胞病毒是最常见的病原体。在发达国家,血培养很少呈阳性,死亡率也很低。呼吸急促和听诊时出现啰音是提示肺炎的主要表现,但它们的敏感性和特异性不够高,如有可能,应进行胸部X光检查以确诊。抗生素治疗的建议各不相同。根据病因学研究,我们建议门诊患者首选大环内酯类药物,住院患者则根据临床表现和病情严重程度使用青霉素G、大环内酯类药物或头孢呋辛加用大环内酯类药物。肺炎患儿通常恢复迅速,在无并发症的情况下,无需进行常规的随访X光检查和复查。

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