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[儿童支原体肺炎相关性缺血性脑卒中的临床特征及文献复习]

[Clinical characteristics of Mycoplasma pneumoniae-associated ischemic stroke in children, and a literature review].

作者信息

Kong Min, Jiang Li, Hu Jun, Ye Yuan-Zhen

机构信息

Department of Neurology, Affiliated Children's Hospital of Chongqing Medical University, Chongqing 400014, China.

出版信息

Zhongguo Dang Dai Er Ke Za Zhi. 2012 Nov;14(11):823-6.

Abstract

OBJECTIVE

To study the clinical characteristics of Mycoplasma pneumoniae (MP)-associated ischemic stroke in children.

METHODS

The case of a girl with MP-associated ischemic stroke was reported, including clinical manifestations and laboratory and imaging examinations, and related literature was reviewed.

RESULTS

The girl, who was suffering from a respiratory tract infection was found to have hemiplegia and aphasia which were expressed in ischemic stroke. IgM antibody to MP in serum (1∶320) and lavage fluid was positive. Pulmonary imaging showed unilateral consolidation and pleural exudate. Cerebral neuroimaging examination showed occlusion of the bilateral middle cerebral artery, mainly on the left side. The neurological symptoms and signs were recovered after comprehensive therapy with medication (azithromycin, hormone and heparin) and rehabilitation training.

CONCLUSIONS

Ischemic stroke is rare but severe manifestation of central nervous system damage in children suffering from MP infection. Cerebral imaging and etiological examinations contribute to the diagnosis. Early use of macrolide antibiotics, anticoagulant and hormone may improve the prognosis.

摘要

目的

研究儿童支原体肺炎(MP)相关缺血性脑卒中的临床特征。

方法

报告1例MP相关缺血性脑卒中女童病例,包括临床表现、实验室及影像学检查,并复习相关文献。

结果

该女童患呼吸道感染,出现缺血性脑卒中表现的偏瘫和失语。血清及灌洗液中MP IgM抗体(1∶320)阳性。肺部影像学显示单侧实变及胸腔积液。颅脑神经影像学检查显示双侧大脑中动脉闭塞,以左侧为主。经阿奇霉素、激素及肝素药物综合治疗及康复训练后,神经症状及体征恢复。

结论

缺血性脑卒中是MP感染儿童中枢神经系统损伤的罕见但严重表现。脑部影像学及病因学检查有助于诊断。早期使用大环内酯类抗生素、抗凝剂及激素可能改善预后。

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