Berger R P, Wadowksy R M
Pediatrics. 2000 Feb;105(2):433-6. doi: 10.1542/peds.105.2.433.
Mycoplasma pneumoniae is responsible for approximately 20% of the cases of community-acquired pneumonia. The onset of respiratory symptoms is gradual and systemic complaints such as headache, malaise, arthalgias, and low-grade fever are frequently prominent. Extrapulmonary manifestations of M pneumoniae are common and hematologic (thrombocytopenia, splenomegaly, disseminated intravascular coagulation, hemolytic anemia), dermatologic (Stevens-Johnson syndrome), gastrointestinal (vomiting, diarrhea, pancreatitis), renal (interstitial nephritis, glomerulonephritis), cardiac (pericarditis, myocarditis, pericardial effusion) and central nervous system (meningitis, transverse myelitis, polyradiculopathy, cerebellar ataxia, sensorineural hearing loss) complications can occur.
We describe the case of an adolescent girl with massive rhabdomyolysis associated with an infection caused by M pneumoniae. We briefly review the differential diagnosis of a patient presenting with acute rhabdomyolysis and discuss the use of a new polymerase chain reaction-based assay for direct detection of M pneumoniae in throat swab specimens.
Clinicians should be aware of a possible association between rhabdomyolysis and infection with M pneumoniae and should consider testing for M pneumoniae when they are presented with a patient with idiopathic rhabdomyolysis. The new polymerase chain reaction-based assay for detection of M pneumoniae is a more accurate and more efficient method than traditional culture.
肺炎支原体约占社区获得性肺炎病例的20%。呼吸道症状起病缓慢,头痛、不适、关节痛和低热等全身症状常常较为突出。肺炎支原体的肺外表现很常见,可出现血液系统(血小板减少、脾肿大、弥散性血管内凝血、溶血性贫血)、皮肤(史蒂文斯-约翰逊综合征)、胃肠道(呕吐、腹泻、胰腺炎)、肾脏(间质性肾炎、肾小球肾炎)、心脏(心包炎、心肌炎、心包积液)和中枢神经系统(脑膜炎、横贯性脊髓炎、多发性神经根病、小脑共济失调、感音神经性听力损失)并发症。
我们描述了一名青春期女孩的病例,该女孩患有与肺炎支原体感染相关的大面积横纹肌溶解症。我们简要回顾了急性横纹肌溶解症患者的鉴别诊断,并讨论了一种基于新型聚合酶链反应的检测方法在咽喉拭子标本中直接检测肺炎支原体的应用。
临床医生应意识到横纹肌溶解症与肺炎支原体感染之间可能存在关联,当遇到特发性横纹肌溶解症患者时应考虑检测肺炎支原体。用于检测肺炎支原体的新型基于聚合酶链反应的检测方法比传统培养方法更准确、更高效。