Laboratory of Pediatrics, Erasmus MC-Sophia Children's Hospital, University Medical Center, Rotterdam, The Netherlands.
Laboratory of Pediatrics, Erasmus MC-Sophia Children's Hospital, University Medical Center, Rotterdam, The Netherlands; Division of Infectious Diseases and Hospital Epidemiology, and Children's Research Center (CRC), University Children's Hospital of Zurich, Zurich, Switzerland.
J Infect. 2017 Jun;74 Suppl 1:S95-S100. doi: 10.1016/S0163-4453(17)30198-6.
M. pneumoniae infection gives rise to a wide variety of manifestations. The pathogenesis of secondary manifestations is not always known. Some depend on the direct invasion of M. pneumoniae and others on the indirect effect of M. pneumoniae through pathological immune responses, for instance autoreactive antibodies in Guillain-Barré Syndrome. Diagnosis remains challenging with currently available diagnostic tests, because they do not demonstrate a causal relation due to M. pneumoniae asymptomatic carriage or previous infection. The mainstay of treatment is macrolide antibiotics, but the role of additional immunomodulation therapy is unclear. Knowledge of the pathogenesis of the different manifestations should guide strategies for diagnosis and treatment.
肺炎支原体感染可引起多种表现。继发性表现的发病机制并不总是明确的。一些取决于肺炎支原体的直接侵袭,另一些则取决于肺炎支原体通过病理性免疫反应的间接作用,例如格林-巴利综合征中的自身反应性抗体。目前可用的诊断检测方法的诊断仍然具有挑战性,因为由于肺炎支原体无症状携带或既往感染,它们并不能证明因果关系。治疗的主要方法是大环内酯类抗生素,但额外免疫调节治疗的作用尚不清楚。对不同表现的发病机制的了解应指导诊断和治疗策略。