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[一名复发性扁桃体炎、支气管炎和渗出性中耳炎患者中肺炎衣原体和沙眼衣原体的检出]

[Recovery of Chlamydia pneumoniae and Chlamydia trachomatis in a patient with recurrent tonsillitis, bronchitis and otitis media with effusion].

作者信息

Ogawa H, Hashiguchi K, Kazuyama Y

机构信息

Ear, Nose and Throat Clinic, Kitasato Institute Hospital.

出版信息

Kansenshogaku Zasshi. 1991 Feb;65(2):234-8. doi: 10.11150/kansenshogakuzasshi1970.65.234.

Abstract

We report a case of recurrent tonsillitis and otitis media with effusion (OME) from which Chlamydia trachomatis was isolated. Chlamydia pneumoniae, a newly recognized species of Chlamydia, was also recovered from the tonsillar and bronchial swabs. A 8-year-old girl was seen on February 23, 1988, because of a running nose, a productive cough and bilateral hearing difficulty. She had a history of recurrent tonsillitis. The diagnosis was acute sinusitis with tubal obstruction, then cefixime was prescribed. Her symptoms were once resolved, for the time being but she came back to the hospital a week later with a bilateral ear-ache. The tympanic membranes were injected and characteristically retracted. Her left ear showed type B tympanogram (effusion). Tympanocentesis was performed to remove middle-ear effusion, from which C. trachomatis but no ordinary bacterium was isolated. Therefore rokitamycin 300 mg/day was administered for a week. Her condition improved, however, a rhinorrhea, a plugged ear sensation and a hacking cough returned in a month. She was admitted to the hospital on May 10, for tympanostomy and grommet insertion, but from the day before admission, she had a sore throat with fever (39.2 degrees C). The surgery was withheld until May 26. When adenotonsillectomy and grommets insertion were undertaken, C. trachomatis had disappeared from the middle-ear effusion, but C. pneumoniae was recovered from both tonsillar and bronchial swabs. Readministration of rokitamycin was performed and to date (June, 1990) she remains well.

摘要

我们报告一例复发性扁桃体炎合并渗出性中耳炎(OME),从中分离出沙眼衣原体。还从扁桃体和支气管拭子中分离出肺炎衣原体,这是一种新发现的衣原体菌种。一名8岁女孩于1988年2月23日就诊,症状为流鼻涕、咳痰和双侧听力困难。她有复发性扁桃体炎病史。诊断为急性鼻窦炎伴咽鼓管阻塞,随后开了头孢克肟。她的症状暂时缓解,但一周后又回到医院,出现双侧耳痛。鼓膜充血且特征性内陷。左耳呈B型鼓室图(积液)。进行鼓膜穿刺以清除中耳积液,从中分离出沙眼衣原体但未分离出普通细菌。因此给予罗他霉素300mg/天,持续一周。她的病情有所改善,然而,一个月后又出现了流鼻涕、耳闷和干咳。她于5月10日入院接受鼓膜造孔和鼓膜置管术,但在入院前一天,她出现了喉咙痛伴发热(39.2℃)。手术推迟到5月26日。当进行腺样体扁桃体切除术和鼓膜置管术时,中耳积液中已未检测到沙眼衣原体,但扁桃体和支气管拭子中分离出了肺炎衣原体。再次给予罗他霉素治疗,截至1990年6月,她情况良好。

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