支原体肺炎。

P S Jensen, M D Halber, C E Putman
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引用次数: 0

摘要

肺炎支原体是肺炎的常见病因。当患者出现原发性非典型肺炎的症状,包括咳嗽、发热、寒战、头痛和不适,并伴有节段性或亚节段性肺浸润,白细胞计数正常或仅轻微升高,痰革兰氏染色(如有)显示多形核白细胞和少量细菌时,应怀疑诊断。当患者表现出非肺炎的症状,包括嗜睡、呼吸困难和1- 4周的呼吸短促病史,无咳嗽或发热,伴有弥漫性网状结节性或肺间质性浸润时,诊断更为困难。先前健康的宿主的疾病通常是良性和自限性的。然而,服用四环素衍生物或红霉素可缩短病程。肺炎支原体肺炎可与其他疾病相关,包括镰状细胞性贫血、结节病、系统性红斑狼疮、霍奇金病和各种其他免疫缺陷状态。在这些患者中,支原体肺炎可能非常严重。虽然没有典型的临床或影像学表现,但仔细考虑流行病学、临床、实验室和影像学资料通常足以建议大多数患者的诊断。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Mycoplasma pneumonia.

M. pneumoniae is a common cause of pneumonia. The diagnosis is suspected when the patient presents with symptoms suggesting primary atypical pneumonia including cough, fever, chills, headache, and malaise in association with a segmental or subsegmental pulmonary infiltrate(s), the white blood cell count is normal or only slightly elevated, and the Gram stain of the sputum (if any can be obtained) reveals polymorphonuclear leukocytes and few bacteria. The diagnosis is more difficult when the patient presents with symptoms not suggestive of pneumonia including lethargy, dyspnea, and a 1- to 4-week history of shortness of breath without cough or fever in association with diffuse reticulonodular or interstitial pulmonary infiltrates. The disease in the previously healthy host is usually benign and self-limiting. However, the course is shortened by the administration of tetracycline derivatives or erythromycin. M. pneumoniae pneumonia can occur in association with other diseases including sickle cell anemia, sarcoidosis, systemic lupus erythematosus, Hodgkin's disease, and various other immunodeficiency states. In these patients mycoplasma pneumonia can be very serious. Although there is no pathognomonic clinical or radiographic presentation, careful consideration of epidemiologic, clinical, laboratory, and radiographic data are usually sufficient to suggest the diagnosis in most patients.

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