Bosland A, Arlaud K, Rousset-Rouvière C, Fouilloux V, Paut O, Dubus J-C, Bosdure E
Unité de médecine infantile, CHU Timone-Enfants, Marseille, France.
Arch Pediatr. 2011 Dec;18(12):1310-4. doi: 10.1016/j.arcped.2011.09.027. Epub 2011 Oct 29.
We report 2 cases of children with group A streptococcus pyogenes pleuropneumonia, in one child associated with Kawasaki disease and in the other with streptococcal toxic shock syndrome. These 2 features, with theoretically well-defined clinical and biological criteria, are difficult to differentiate in clinical practice, however, likely due to their pathophysiological links. In case of clinical doubt, an echocardiography needs to be performed to search for coronary involvement and treatment including intravenous immunoglobulins, and an antibiotic with an anti-toxin effect such as clindamycin has to be started early.
我们报告了2例患有A组化脓性链球菌胸膜肺炎的儿童病例，其中1例与川崎病相关，另1例与链球菌中毒性休克综合征相关。这两种疾病，虽然在理论上有明确的临床和生物学标准，但在临床实践中却难以区分，这可能是由于它们在病理生理学上的联系。如果临床上存在疑问，需要进行超声心动图检查以寻找冠状动脉受累情况，并开始包括静脉注射免疫球蛋白在内的治疗，同时必须尽早开始使用具有抗毒素作用的抗生素，如克林霉素。
