儿童肺炎支原体感染致多形红斑3例

Erythema multiforme caused by Mycoplasma pneumoniae infection in 3 children

目的:总结肺炎支原体感染引起多形红斑患儿的临床特点、诊断及治疗。方法:回顾性分析2016年6月至2019年12月郑州大学第一附属医院收治的肺炎支原体感染引起的多形红斑患儿的临床特点及治疗、转归,并对相关文献进行复习。结果:3例患儿均有发热、皮肤和黏膜损害,皮肤损害表现为渗出性多形性红斑,受累的黏膜包括口腔黏膜、眼结膜及生殖器黏膜,均接受糖皮质激素、大剂量丙种球蛋白、抗支原体及对症支持治疗后好转,2例在治疗过程中继发细菌感染,加强抗感染治疗后好转,随访均无后遗症发生。结论:肺炎支原体感染可引起儿童多形红斑,临床少见,常被误诊,其发病机制尚不明确,及早予糖皮质激素、丙种球蛋白、抗肺炎支原体及对症支持治疗往往预后良好。

Objective To summarize the clinical features,diagnosis and treatment of erythema multiforme caused by Mycoplasma pneumoniae infection.Methods The data of clinical features,treatment and prognosis of children diagnosed with erythema multiforme caused by Mycoplasma pneumoniae infection and treated in the First Affiliated Hospital of Zhengzhou University from Jane 2016 to December 2019 were retrospectively analyzed,and related literature was summarized.Results All the 3 patients suffered from fever,cutaneous and mucous membrane lesions.Cutaneous lesions were manifested as exudative erythema multiforme,and the mucous membranes involved included oral mucosa,ocular conjunctiva and genital mucosa.The symptoms in all 3 cases were alleviated after the treatment with glucocor-ticoid,high doses of gamma globulin,anti-Mycoplasma pneumoniae and symptomatic support.Two children suffered secondary infection during treatment and improved with anti-infection.Neither patients had sequelae during the follow-up.Conclusions Mycoplasma pneumoniae can cause erythema multiforme in children,but it is always misdiagnosed due to its clinical rarity.The mechanism of erythema multiforme caused by Mycoplasma pneumoniae infection is not clear.Early administration of glucocorticoid and high doses of gamma globulin,anti-Mycoplasma pneumoniae and symptomatic support often lead to a good prognosis.