Department of pediatrics, Ezhou Central Hospital, Ezhou, Hubei, China.
Immun Inflamm Dis. 2023 Oct;11(10):e955. doi: 10.1002/iid3.955.
In recent years, there has been an increase in the number of patients diagnosed with pediatric diseases who have severe Mycoplasma pneumoniae (MP) pneumonia, and there has also been an increased attention to serious extrapulmonary complications. However, cases with abdominal pain, acute abdomen, scrotal swelling and pain, and fever as the primary symptoms have been rarely reported.
A 3-years-and-8-months-old male patient diagnosed with pediatric disease was reported with abdominal pain, scrotal swelling and pain, and fever as the primary symptoms in the present study. No respiratory symptoms were observed throughout the disease. Through computed tomography (CT) scanning, the patient was diagnosed with severe MP pneumonia based on the symptoms of abdominal pain and fever, as well as pulmonary infection, pleural effusion, and retroperitoneal exudation. Laboratory tests supported the diagnosis of MP infection, and the diagnosis was confirmed by severe MP pneumonia. The therapeutic effects of azithromycin were poor, and the symptoms were quickly alleviated with the addition of gamma globulin and methylprednisolone. After discharge, azithromycin sequential therapy was administered. The chest CT was normal at the follow-up 1-month later.
Severe MP pneumonia in patients with pediatric diseases may include abdominal pain, scrotal swelling and pain, and fever as the primary symptoms. Care should be taken to avoid missed diagnoses and misdiagnoses in clinical practice.
近年来，儿童患严重肺炎支原体（MP）肺炎的病例增多，对其严重肺外并发症的关注度也有所增加。然而，以腹痛、急性腹痛、阴囊肿胀和疼痛以及发热为主要症状的病例很少见。
本研究报道了 1 例以腹痛、阴囊肿胀和疼痛以及发热为主要症状的儿科疾病患儿。在整个疾病过程中均未观察到呼吸道症状。通过计算机断层扫描（CT）扫描，根据腹痛和发热的症状以及肺部感染、胸腔积液和腹膜后渗出，诊断为严重 MP 肺炎。实验室检查支持 MP 感染的诊断，根据严重 MP 肺炎确诊。阿奇霉素治疗效果不佳，加用丙种球蛋白和甲基强的松龙后症状迅速缓解。出院后，给予阿奇霉素序贯治疗。1 个月后随访时胸部 CT 正常。
儿科疾病患者的严重 MP 肺炎可能包括腹痛、阴囊肿胀和疼痛以及发热为主要症状。在临床实践中应注意避免漏诊和误诊。
