摘要
报告1例肺炎支原体肺炎合并Stevens-Johnson综合征(SJS)。患儿男,6岁。因发热、咳嗽3 d入院。胸部X射线检查提示左中下肺野炎性病变。血清肺炎支原体抗体(MP-IgM)阴性,考虑肺炎,予静脉滴注头孢地嗪联合口服阿奇霉素抗感染,静脉滴注甲泼尼龙抗炎治疗。治疗第5天患儿体温正常,第6天咳嗽好转,肺部炎症吸收,复查MP-IgM示1∶320(<1∶40),诊断肺炎支原体肺炎。治疗第7天,患儿出现一过性低热及斑丘疹。皮肤科检查:口唇肿胀,口腔黏膜充血、破溃;双眼结膜充血伴大量分泌物;手足皮肤散在疱疹及靶形红斑。诊断:肺炎支原体肺炎合并SJS。入院第9天予静脉滴注静脉注射用人免疫球蛋白联合甲泼尼龙治疗后,患儿皮肤及黏膜损害改善。治疗第12天,复查MP-IgM示1∶1280,患儿好转出院。随访至今未复发。
A case of Mycoplasma pneumoniae pneumonia(MPP)associated with Stevens-Johnson syndrome(SJS)is reported.A 6-year-old boy was admitted to hospital with fever and cough for 3 days.The chest imaging showed inflammatory lesions in the left middle and lower fields.Serum Mycoplasma pneumoniae antibody(MP-IgM)was negative,and pneumonia was considered.The patient was treated with cefodizime combined with azithromycin for anti-infection and methylprednisolone for anti-inflammation.On the 5th day of treatment,his body temperature was back to normal.On the 6th day,his cough was improved,the pulmonary inflammation was absorbed,the MP-IgM was 1∶320(<1∶40),and a diagnosis of MPP was confirmed.On day 7,the patient developed transient low fever and maculopapular rash.Dermatological examination showed lip swelling,oral mucosa congestion,ulceration,conjunctival congestion of both eyes with prominent discharge,as well as scattered blisters and target erythema on hands and feet.The diagnosis of MPP with SJS was made.On the 9th day,the patient was treated with intravenous infusion of human immunoglobulin combined with methylprednisolone,the skin and mucosal lesion improved on the day of treatment.On the 12th day,the MP-IgM was 1∶1280,the patient recovered and was discharged.There was no recurrence during follow-up.
作者
郭素香
王浩
王旋
陈慧
GUO Suxiang;WANG Hao;WANG Xuan;CHEN Hui(Department of Pediatrics,The Second Affiliated Hospital of Tianjin University of Chinese Medicine,Tianjin 300250,China;School of Graduate Studies,Tianjin University of Traditional Chinese Medicine,Tianjin 301617,China)
出处
《临床皮肤科杂志》
CAS
CSCD
北大核心
2023年第10期603-606,共4页
Journal of Clinical Dermatology
