- 期刊
Clinical Study of Mycoplasma Pneumoniae Penumonia
黴漿菌肺炎之臨床研究
摘要
自1982年至1991年間，吾人共經歷76例經血清學檢驗證實之黴漿肺炎病例，其中男性32人，女性44人，年齡從9個月到72歲，除了一例有糖尿病史外，其餘患者過去健情況良好，所有病人均表現發燒及咳之症狀，其中百分之六十三主訴乾核，百分之三十七咳嗽帶痰，57％的病人有喉嚨痛，流鼻水或耳朵痛的症狀，55％的病人有骨腸道的症狀，如食慾不振、噁心，嘔吐國腹瀉，其他症狀如肌肉或關節酸痛（29％），頭痛（30％），全身倦怠（32％），部份病人有呼吸困難（17％）或胸痛（20％）之敘述，實驗室檢查，29％的病人白血球計數大於10000/cumm，平均CRP值53.1μg/ml，其中16％CRP大於100μg/ml，31.5％的病人有短暫的肝功能異常，病人胸部X光影像可分四種不同之表現：第一，支氣管及血管週邊間質性浸潤佔18.4％；第二，不均勻斑珀性肺實質化佔22.4％；第三，均勻之肺泡性實質化佔27.6％；第四，混合間質性及肺泡性浸潤佔31.6％。小兒科病人胸部X光表現間質性浸潤之比率較成人多（46％：20％），其他放射線學之特徽包括80％病灶為單側性，77％病灶局限於單一肺葉，69％病灶侵犯一側或兩側下肺葉，7％病人有肋膜積液，10％病人有胸部X光之惡化，肺炎之鑑別診斷應慎重考慮黴漿菌之可能性，而給予適當之處置。
關鍵字
無資料並列摘要
From 1982 to 1991, we experienced 76 patients with Mycoplasma pneumoniae pneumonia which were confirmed by serologic tests. There were 32 (42%) male and 44 (58%) female patients. One patient had underlying disease of diabetes mellitus while the other patients were in good health. The age ranged from 9 months old to 72 years old. All the patients complained of fever and coughing; 63% had dry cough and 37% had sputum production. Upper respiratory tract complaints such as rhinorrhea, sore throat, or earache were noted in 57% of the patients. Fifty-five percent of the patients had GI symptoms of anorexia, nausea, vomiting, or diarrhea. Other complaints included myalgia/arthalgia (29%), headache (30%), and general malaise (32%). Dyspnea (17%) and chest pain (20%) were occasional complaints. Seventy-one percent of the patients had WBC counts ＜ 10000/cu mm and 29% ＞ 10000/cu mm. The mean value of C-reactive protein (CRP) was 53.1μg/ml, while 16% of the patients had a CRP value above 100μg/ml. Thirty-one percent of the patients were noted to have a transient elevation of serum transaminase. Four different patterns of infiltration were seen in chest radiographic manifestation: 1) peribronchial and perivascular interstitial infiltrates (18.4%), 2) nonhomogeneous patchy consolidations (22.4%), 3) homogeneous acinar consolidations (27.6%), and 4) mixed interstitial and alveolar infiltrates (27.6%). Interstitial infiltration was more commonly seen in pediatric than adult patients (46% vs 20%). Other features of the radiologic manifestation were as follows: unilateral lesions in 80% of patients, single lobe ldsions in 77%, lower lobe predominant in 69%, pleural effusion in 7%, and radiographic deterioration in 10%. Mycoplasmal pneumonia should be considered in the differential diagnosis of community-acquired pneumonias.