Zhang Tongqiang, Han Chunjiao, Guo Wei, Ning Jing, Cai Chunquan, Xu Yongsheng
Department of Pulmonology, Tianjin Children's Hospital/Tianjin University Children's Hospital, Tianjin, China.
Clinical School of Paediatrics, Tianjin Medical University, Tianjin, China.
Front Pediatr. 2021 Dec 9;9:741663. doi: 10.3389/fped.2021.741663. eCollection 2021.
Fulminant pneumonia (FMPP) accounts for 0.5-2% of all MPP cases, which is considered as MPP combined with severe complications such as hypoxemia, acute respiratory distress syndrome, or acute respiratory failure. It primarily affects young adults with no underlying disease. Although some studies have proved the severity of FMPP, the details about clinical diagnosis and treatment of FMPP in children have been rarely reported. In this case study, we described three cases who suffered from FMPP. These children not only developed acute lung injury and multiple organ involvement within 7 days of treatment, but were also found plastic bronchitis by bronchoscopy. Finally, all the patients were treated successfully with azithromycin, glucocorticoid, and bronchoscopy lavage. We conclude that this case study would contribute to raise awareness with respect to FMPP, which may occur at a younger age with faster disease progression and common extrapulmonary manifestations. It also reinforces the importance of early identification and prompt intervention to save life of children and reduces sequelae. Further studies are needed about mechanism of FMPP.
暴发性肺炎(FMPP)占所有支原体肺炎(MPP)病例的0.5%-2%,被认为是MPP合并低氧血症、急性呼吸窘迫综合征或急性呼吸衰竭等严重并发症。它主要影响无基础疾病的年轻人。尽管一些研究证实了FMPP的严重性,但关于儿童FMPP临床诊断和治疗的细节鲜有报道。在本病例研究中,我们描述了3例FMPP患儿。这些患儿不仅在治疗7天内出现急性肺损伤和多器官受累,还通过支气管镜检查发现了塑形支气管炎。最后,所有患者均通过阿奇霉素、糖皮质激素和支气管镜灌洗成功治愈。我们得出结论,本病例研究将有助于提高对FMPP的认识,FMPP可能发生在更年轻的年龄段,疾病进展更快且有常见的肺外表现。它还强化了早期识别和及时干预对挽救儿童生命及减少后遗症的重要性。关于FMPP的机制还需要进一步研究。