- 期刊
Chlamydia Trachomatis Pneumonia: Experience in a Medical Center
砂眼披衣菌肺炎：一個醫學中心過去十年的經驗
摘要
披衣菌肺炎為嬰兒早期肺炎重要致病原之一。研究對象為在1994到2003年十年當中，因披衣菌肺炎而住院的嬰兒，本研究主要目的是以回溯方式分析這些病童的年齡、生產方式、臨床表現、實驗室數據、治療和愈後。以M型免疫球蛋白抗體、培養或是聚合鏈反應的結果為診斷依據。結果共有30位病人符合資格，年齡分布從10天至5個月大，發病平均年齡為62.47天，大多數病童小於4個月(96.67%)，最常見的臨床表徵為咳嗽有痰之後合併有呼吸窘迫情形，大多數病童並無發燒，僅3名病童有發燒情形，而這3名病童其中有兩人合併呼吸道融合病毒感染，發病時4名病童同時有結膜發炎情形，3名病童出現呼吸暫停的情況，實驗室數據發現14名病童有嗜依紅性白血球升高情形，胸部X光檢查發現15位(50%)出現肺部過度充氣情形，病童對於紅黴素治療反應良好，平均住院天數為8.97天，其中無死亡案例。此研究可提醒臨床醫師，披衣菌肺炎常發生於小於4個月嬰兒，在臨床表現、實驗室數據和X光檢查有其典型特徵，若治療不適當，病人可能出現呼吸暫停甚至呼吸衰竭情形。
並列摘要
Chlamydia trachomatis is one of the important causes of afebrile pneumonia in infants. The purpose of this study was to evaluate the demographic features, clinical manifestations, and outcome of C. trachomatis pneumonia patients seen during the past 10 years in one medical center. We reviewed the records on 30 patients with a diagnosis of C. trachomatis pneumonia. The diagnosis was based on characteristic clinical features and confirmed by culture, serologic testing, or polymerase chain reaction (PCR). Clinical features including age, sex, symptoms at the time of admission, laboratory data, and treatment were analyzed. Of the 30 patients (17 males and 13 females), 29 (96%) were less than 4 months old (range 10 days to 5 months). All patients had productive cough followed by tachypnea. Three patients (10%) presented with apnea. Four (13%) had conjunctivitis. Fever was present in only 3 (10%), of whom 2 also had concurrent respiratory syncytial virus infection. Peripheral eosinophilia (eosinophils≧400/mm^3) was present in 14 (47%) patients. Hyperinflation was seen on chest x-ray in 15 patients. All infants were treated with erythromycin and responded well. The mean time to clinical improvement was 3.53 days after the start of treatment. The mean duration of hospitalization was 8.97 days (range, 3 to 17 days). No patients died. Pediatricians and general practitioners must have a high index of suspicion for chlamydial infection in afebrile infants presenting with tachypnea, peripheral eosinophilia, and hyperinflation on chest x-ray during the first four months of life.