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儿童和婴幼儿肺炎支原体感染的临床表现。

Clinical manifestations in infants and children with Mycoplasma pneumoniae infection.

机构信息

Department of Paediatrics, Nordsjællands Hospital, Hillerød, Denmark.

Department of Clinical Microbiology, Herlev Hospital, Herlev, Denmark.

出版信息

PLoS One. 2018 Apr 26;13(4):e0195288. doi: 10.1371/journal.pone.0195288. eCollection 2018.

Abstract

BACKGROUND

Mycoplasma pneumoniae is a common cause of community-acquired pneumonia in older children. Pulmonary and extra-pulmonary symptoms associated with M. pneumoniae infection are reported. M. pneumoniae is mainly epidemic in Denmark with the recurrence every 4-7th year.

AIMS

Retrospectively, to describe the epidemiology and clinical features, in infants and children, during the M. pneumoniae epidemic in 2010 and 2011.

METHODS

All children under the age of 16 that were tested for M. pneumoniae during the period 01.02.2010-31.01.2012 were included. Medical charts, as well as radiological findings, were reviewed for all children with M. pneumoniae. A post-hoc analysis of viral co-infections was done on part of the cohort.

RESULTS

134 of 746 children were tested positive for M. pneumoniae by PCR or serology. Positive tests were found in 65% of children seven years and older, in 30% of 2-6-year-olds and 4% of infants (less than two years of age). Viral co-infection was found in 27% of the tested samples. The clinical presentation was a cough, asthma-like symptoms and low-grade fever. Extra-pulmonary symptoms were common and presented as nausea/vomiting by 33% of the children and skin manifestations by 25%. 84% of the children had a chest x-ray taken, and there were positive radiological findings in 94% of these.

CONCLUSION

M. pneumoniae also affected infants and young children and symptoms were similar to infections with respiratory viruses, but severe LRTI were also seen. During an up-coming epidemic, assessment of extra-pulmonary manifestations can be helpful when diagnosing M. pneumoniae infections.

摘要

背景

肺炎支原体是年长儿童社区获得性肺炎的常见病因。据报道,肺炎支原体感染与肺部和肺外症状有关。肺炎支原体在丹麦主要流行,每 4-7 年复发一次。

目的

回顾性描述 2010 年和 2011 年肺炎支原体流行期间婴儿和儿童的流行病学和临床特征。

方法

纳入在此期间(2010 年 2 月 1 日至 2012 年 1 月 31 日)接受肺炎支原体检测的所有 16 岁以下儿童。对所有肺炎支原体阳性的患儿的病历和影像学检查结果进行回顾。对部分队列进行了病毒合并感染的事后分析。

结果

746 名儿童中,134 名通过 PCR 或血清学检测对肺炎支原体呈阳性。7 岁及以上儿童的阳性检测率为 65%,2-6 岁儿童为 30%,2 岁以下婴儿为 4%。检测样本中发现 27%存在病毒合并感染。临床表现为咳嗽、哮喘样症状和低热。肺外症状常见,33%的患儿出现恶心/呕吐,25%的患儿出现皮肤表现。84%的患儿进行了胸部 X 线检查,这些患儿中有 94%的 X 线检查结果呈阳性。

结论

肺炎支原体也可感染婴儿和幼儿,其症状与呼吸道病毒感染相似,但也可见严重的下呼吸道感染。在即将到来的流行期间,评估肺外表现有助于诊断肺炎支原体感染。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0d87/5919654/1cb237ec05ca/pone.0195288.g001.jpg

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