Ko Kyoung H, Kim Min J, Baik Seung H, Yoon Young K
Young Kyung Yoon, MD, PhD, Division of Infectious Diseases,, Department of Internal Medicine,, Korea University Anam Hospital,, Inchon-ro 73, Seongbuk-gu,, Seoul 136-705, South Korea, T: +82-2-920-5096, F: +82-2-920-5616,
Ann Saudi Med. 2016 Jan-Feb;36(1):81-4. doi: 10.5144/0256-4947.2016.81.
Although pneumonia is the hallmark of Mycoplasma pneumoniae infections, it has been associated with protean manifestations such as extrapulmonary involvement. Herein, a rare case of mononuclear syndrome with acute hepatitis and erythema multiforme revealed as M pneumoniae infection without lung involvement is reported. A 30-year-old man, previously healthy, presented with fever and rash with acute hepatitis: AST 603 IU/L, ALT 747 IU/L, prothrombin time 52%. Peripheral blood smears indicated monocytosis with atypical lymphocyte. Bone marrow biopsy revealed increased plasma cell infiltration. M pneumoniae infection was detected by serology testing. After treatment with macrolide, clinical symptoms and signs and serological tests were fully resolved. Diagnosis of this etiologic association is important when patients present with various clinical syndromes without pneumonia, because only specific antimicrobial therapy is effective against M pneumoniae.
虽然肺炎是肺炎支原体感染的标志，但它也与多种表现相关，如肺外受累。本文报告了一例罕见的单核细胞增多综合征，表现为急性肝炎和多形红斑，经诊断为肺炎支原体感染但无肺部受累。一名30岁既往健康的男性，出现发热、皮疹伴急性肝炎：谷草转氨酶603 IU/L，谷丙转氨酶747 IU/L，凝血酶原时间52%。外周血涂片显示单核细胞增多伴非典型淋巴细胞。骨髓活检显示浆细胞浸润增加。通过血清学检测发现肺炎支原体感染。经大环内酯类药物治疗后，临床症状、体征及血清学检查完全恢复正常。当患者出现无肺炎的各种临床综合征时，诊断这种病因关联很重要，因为只有特定的抗菌治疗对肺炎支原体有效。
