通讯作者: 李少军, lishaojun1980@hotmail.com

DOI：10.12201/bmr.202408.00042

Mycoplasma pneumoniae encephalitis in children: a case report and literature review

• 摘要：目的：探讨儿童肺炎支原体脑炎(Mycoplasma pneumoniae encephalitis,MPE)的临床特点,为临床治疗提供参考依据。方法：回顾分析1例MPE患儿的临床资料,并复习相关文献,总结MPE临床特点及目前诊断、治疗方法及预后。结果：7岁女童,以发热、咳嗽伴头痛为主要临床表现,体检发现双肺呼吸音降低,左肺少量中粗湿罗音。肺部影像学示左肺大片实变伴不张,有支气管闭塞,支气管镜下诊断塑型性支气管炎。咽分泌物MP核酸检测阳性,脑电图示背景慢化,神经影像学检查有左侧额叶及半卵圆中心信号异常,结合后期出现偏瘫诊断MPE明确。通过左氧氟沙星、甲泼尼龙及IVIG治疗后症状好转。检索到近5年16篇文献317例MPE患儿,发热为最多见前驱症状,多数患儿经过抗MP、糖皮质激素及IVIG治疗预后良好。结论：儿童MPE缺乏特异性临床表现,尚无统一诊断标准和标准化治疗方案,应警惕MP流行期间的儿童脑炎,早期诊治对缓解症状及改善预后具有积极作用。

  关键词： 肺炎支原体; 临床特点; 脑炎; 儿童

   

  Abstract: ［］Objective: To explore the clinical characteristics of Mycoplasma pneumoniae encephalitis(MPE).Methods: The clinical data of MPE in a child was retrospectively analyzed, and the related literature was reviewed. The clinical features, current diagnostic and treatment methods of MPE were summarized. Results: A 7-year-old girl with fever, cough, and headache as the main clinical manifestation. Physical examination revealed a decrease in respiratory sounds in both lungs and a small amount of coarse moist rales in the left lung. Pulmonary imaging showed extensive consolidation of the left lung with atelectasis and bronchial occlusion. Diagnosed plastic bronchitis under bronchoscopy. Positive MP nucleic acid test for pharyngeal secretions, electroencephalogram indicating background slowing, neuroimaging examination indicating abnormal signal in the left frontal lobe and centrum semiovale. Combined with the later onset of hemiplegia, the MPE diagnosis is clear.Symptoms improved after treatment with levofloxacin, methylprednisolone, and IVIG.From the search, sixteen papers were retrieved including a total of 317 cases in the past five years. Fever was the most common precursor symptom. Most patients have a good prognosis after receiving anti-MP, glucocorticoids, and IVIG treatment. Conclusion: Children with MPE lack specific clinical manifestations, and there is no unified diagnostic standard or standardized treatment plan. Clinicians should be alerted to childhood encephalitis during the epidemic of MP. Early diagnosis and treatment play a positive role in relieving symptoms and improving prognosis.

  Key words: ; ; ; 

  提交时间：2024-08-22

  版权声明：作者本人独立拥有该论文的版权，预印本系统仅拥有论文的永久保存权利。任何人未经允许不得重复使用。
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• 序号	提交日期	编号	操作
  1	2024-07-10	bmr.202408.00042V1	下载

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