Ali N J, Sillis M, Andrews B E, Jenkins P F, Harrison B D
Q J Med. 1986 Mar;58(227):241-51.
The clinical, radiographic and microbiological data of 47 patients with Mycoplasma pneumoniae infection admitted to three Norfolk hospitals during a 20-month period between 1982 and 1983 have been reviewed. Thirty-nine presented with pneumonia and eight with non-pulmonary infection. The M. pneumoniae specific IgM test was positive in 42 of 45 patients tested (89 per cent); in 39 the levels were diagnostic on admission. Cold agglutinins were detected in 27 (57 per cent) and a fourfold rise in complement fixation titre was demonstrated in 13 (29 per cent). Sputum culture was positive in 12 (26 per cent). The extrapulmonary manifestations observed were haemolytic anaemia (17 per cent), Stevens Johnson syndrome (4.1 per cent), neurological abnormalities (4.1 per cent), arthritis (2.1 per cent), hepatitis (2.1 per cent) and pericarditis (2.1 per cent). One patient with multilobe pneumonia, pericardial effusion and haemolytic anaemia died. Six patients presented with a history of illness longer than a month; in three the clinical and radiographic picture suggested chronic disease (pulmonary tuberculosis, lymphoma and unresolving pneumonia). There were no distinctive clinical or radiographic features of M. pneumoniae infection. Diagnosis, therefore, relies on serological tests of which the most useful is the rapid, specific IgM test, positive in 86 per cent of the admission sera.
对1982年至1983年期间在诺福克郡三家医院收治的47例肺炎支原体感染患者的临床、影像学和微生物学数据进行了回顾。39例表现为肺炎，8例为非肺部感染。在45例接受检测的患者中，42例（89%）肺炎支原体特异性IgM检测呈阳性；39例在入院时该水平具有诊断意义。27例（57%）检测到冷凝集素，13例（29%）补体结合试验滴度呈四倍升高。痰培养12例（26%）呈阳性。观察到的肺外表现包括溶血性贫血（17%）、史蒂文斯-约翰逊综合征（4.1%）、神经异常（4.1%）、关节炎（2.1%）、肝炎（2.1%）和心包炎（2.1%）。1例患有多叶肺炎、心包积液和溶血性贫血的患者死亡。6例患者病程超过1个月；3例患者的临床和影像学表现提示为慢性病（肺结核、淋巴瘤和未消散的肺炎）。肺炎支原体感染没有独特的临床或影像学特征。因此，诊断依赖于血清学检测，其中最有用的是快速、特异性的IgM检测，在86%的入院血清中呈阳性。
