肺炎支原体感染引起的皮肤和黏膜损害2例分析  

Mycoplasma pneumoniae-induced rash and mucositis:an analysis of two cases

作　　者：杨志国[1] 杨保旺[1] 李兴川[1] 王静[1] 张妮[2] YANG Zhi-guo;YANG Bao-wang;LI Xing-chuan;WANG Jing;ZHANG Ni(Department of Pediatric Intensive Care Unite,Lanzhou University Second Hospital,Lanzhou 730030,China;Department of Pediatric Gastroenterology,Lanzhou University Second Hospital,Lanzhou 730030,China)

机构地区：[1]兰州大学第二医院儿童重症医学科,甘肃兰州730030 [2]兰州大学第二医院小儿消化科,甘肃兰州730030

出　　处：《临床皮肤科杂志》2022年第10期606-610,共5页Journal of Clinical Dermatology

摘　　要：报告2例肺炎支原体感染引起的皮肤和黏膜损害。例1.患儿男,7岁。发热和咳嗽1周,嘴唇溃烂及结膜充血3 d。例2.患儿男,9岁。发热及咳嗽6 d,眼充血及口唇糜烂3 d。2例患儿均无明确药物过敏史,均有发热及呼吸道症状。皮肤科检查示双侧化脓性结膜炎、口腔黏膜及唇出血性糜烂,可见分散的非典型靶形皮损,其中例1患儿生殖器黏膜受累。2例患儿血清病原学检查均示肺炎支原体抗体阳性,胸部X射线检查提示非典型肺炎。2例患儿最终诊断为肺炎支原体感染引起的皮肤和黏膜损害。2例患儿均予静脉滴注阿奇霉素联合甲泼尼龙和大剂量静脉注射用人免疫球蛋白(IVIG)治疗,同时予支持性护理(黏膜和皮肤护理、补充液体以及疼痛管理)。治疗后2例患儿肺炎好转,皮肤和黏膜皮损完全消退,随访3个月后均未复发。Two cases of rash and mucositis induced by Mycoplasma pneumoniae are reported.Case 1.A seven-year-old boy had a history of fever and cough for one week,lip ulceration and conjunctival congestion for three days.Case 2.A nine-yearold boy had fever and cough for six days,eye congestion and lip erosion for three days.Both children had no history of drug allergy,but fever and respiratory symptoms.Dermatological examination showed bilateral purulent conjunctivitis,hemorrhagic ero sions of oral mucosa and lips,and scattered atypical target-shaped lesions,including genital mucosal involvement in case 1.Serologic tests were positive for antibodies to Mycoplasma pneumoniae in both cases,and chest X-rays indicated atypical pneumonia.Both cases were diagnosed as Mycoplasma pneumoniae-induced rash and mucositis.Both children were treated with intravenous azithromycin in combination with methylprednisolone and high-dose intravenous immunoglobulin(IVIG),and supportive care(mucosal and skin care,fluid supplementation,and pain management).After treatment,the pneumonia symptoms subsided,and the skin and mucosal lesions completely resolved.There was no recurrence after three months of follow-up.

关 键 词：肺炎支原体 皮肤损害 黏膜炎 儿童 

分 类 号：R751[医药卫生—皮肤病学与性病学]