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[儿童肺炎衣原体与肺炎支原体双重感染]

[Double infection of Chlamydia pneumoniae and Mycoplasma pneumoniae in children].

作者信息

Terada K, Hiraga Y, Mori R, Yagi Y, Yagi-Shimada Y, Kawano S, Kataoka N, Matsumoto A

机构信息

Department of Pediatrics, Kawasaki Medical School.

出版信息

Kansenshogaku Zasshi. 1996 Nov;70(11):1176-80. doi: 10.11150/kansenshogakuzasshi1970.70.1176.

Abstract

There have been fewer reports on Chlamydia pneumoniae infection during childhood than those in adults, although many of the C. pneumoniae infections occurred during childhood based on prevalence of the antibody. And there have been no reports concerning the double infection of C. pneumoniae and M. pneumoniae. We reported three cases of children with the double infection. We diagnosed this from significant alteration of these antibodies from the acute to convalescent phases. We omitted the cases without significant alteration of the antibodies, even diagnosed from isolation or detection of the antigens in the samples by direct fluorescent antibody. Case 1 was an 8-year-old-boy who was admitted to our hospital because of fever, cough with vomiting and erythema multiforme. The symptoms did not subside after administration of clindamycin but subsided after minocycline. Case 2 was an 1-year-old-boy who was admitted because of fever, cough, rhinorrhea and vomiting. C. pneumoniae organisms were isolated from the pharyngeal swab specimen, the symptoms subsided after administration of clindamycin. Case 3 was a 9-year-old boy who was admitted because of fever and a cough followed by erythema multiforme. The symptoms did not decrease after administration of clindamycin but after minocycline. The characteristic of these cases are a strong cough with vomiting, weak response of acute reactants on the laboratory data, and skin eruption similar with that due to M. mycoplasmae in two of the three cases. We suspect that these double infections may induce the eruption, about which there have been no previous reports.

摘要

与成人相比,关于儿童期肺炎衣原体感染的报道较少,尽管基于抗体的流行率,许多肺炎衣原体感染发生在儿童期。而且尚无关于肺炎衣原体和支原体双重感染的报道。我们报告了3例双重感染的儿童病例。我们通过急性期到恢复期这些抗体的显著变化来诊断。我们排除了抗体无显著变化的病例,即使通过直接荧光抗体从样本中分离或检测到抗原而确诊的病例也被排除。病例1是一名8岁男孩,因发热、咳嗽伴呕吐及多形红斑入院。使用克林霉素后症状未缓解,但使用米诺环素后症状缓解。病例2是一名1岁男孩,因发热、咳嗽、流涕和呕吐入院。从咽拭子标本中分离出肺炎衣原体,使用克林霉素后症状缓解。病例3是一名9岁男孩,因发热和咳嗽,随后出现多形红斑入院。使用克林霉素后症状未减轻,但使用米诺环素后症状减轻。这些病例的特点是剧烈咳嗽伴呕吐、实验室数据中急性反应物反应较弱,且三例中有两例出现与支原体感染相似的皮疹。我们怀疑这些双重感染可能诱发皮疹,此前尚无相关报道。

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