de Boer J, Aerdts S J A, Groeneveld P H P
Department of Internal Medicine, Isala Clinics, Sophia Hospital, PO Box 10400, 8000 GK Zwolle, the Netherlands.
Neth J Med. 2003 Mar;61(3):91-4.
We report a 25-year-old man presenting with high fever, dyspnoea and somnolence. The presence of severe diffuse interstitial pneumonia with extrapulmonary symptoms, such as myositis and subclinical haemolysis, strongly suggested an infection by Mycoplasma pneumoniae. This diagnosis was supported by high titres of cold agglutinins and a positive Coombs test, and directly confirmed by specific IgM serological tests. After initiation of the appropriate antimicrobial treatment mechanical ventilation could be avoided and the patient showed a slow but complete clinical recovery. This diagnosis should be considered in any febrile patient with hypoxaemia and diffuse interstitial pneumonia, and rapid initiation of appropriate antibiotic treatment seems to be crucial for a favourable outcome.
我们报告了一名25岁男性，出现高热、呼吸困难和嗜睡症状。严重弥漫性间质性肺炎伴有肌炎和亚临床溶血等肺外症状，强烈提示为肺炎支原体感染。高滴度冷凝集素和阳性库姆斯试验支持了这一诊断，并通过特异性IgM血清学检测直接确诊。开始适当的抗菌治疗后，避免了机械通气，患者临床症状缓慢但完全恢复。对于任何伴有低氧血症和弥漫性间质性肺炎的发热患者，都应考虑这一诊断，快速开始适当的抗生素治疗似乎对取得良好预后至关重要。
