肺炎支原体诱发反应性感染性皮疹黏膜疹一例  

A case of Mycoplasma pneumoniae-induced reactive infectious mucocutaneous eruption

作　　者：张胜伟 孟召路 热汗古丽·吾休尔 万世森 闫鹏 阳乔 Zhang Shengwei;Meng Zhaolu;Rehangu li;Wuxiuer;Wan Shisen;Yan Peng;Yang Qiao(Department of Infectious Diseases,Zhejiang University Sir Run Run Shaw Alaer Hospital,Alaer 843300,China;Department of Infectious Diseases,Sir Run Run Shaw Hospital,School of Medicine,Zhejiang University,Hangzhou 310016,China)

机构地区：[1]浙江大学医学院附属邵逸夫医院新疆兵团阿拉尔医院感染科,阿拉尔市843300 [2]浙江大学医学院附属邵逸夫医院肝病感染科,杭州市310016

出　　处：《中华实验和临床感染病杂志（电子版）》2024年第5期309-313,共5页Chinese Journal of Experimental and Clinical Infectious Diseases(Electronic Edition)

基　　金：省部共建中亚高发病成因与防治国家重点实验室开放课题资助项目(No.SKL-HIDCA-2023-ALE2);浙江省基础公益研究计划(No.LY21H030011);浙江省医药卫生科技青年创新人才支持计划项目(No.2022RC196)。

摘　　要：目的提高临床对肺炎支原体感染引起反应性感染性皮肤黏膜疹(RIME)的认知,从而对该病进行更准确的治疗和预后判断。方法回顾性分析浙江大学医学院附属邵逸夫医院新疆兵团阿拉尔医院2024年4月11日收治的1例肺炎支原体感染引起RIME患者的临床资料、诊疗经过和预后。结果患者,女性、15岁,因发热、咳嗽伴黏膜糜烂起病,实验室检查显示血清肺炎支原体IgM抗体阳性,咽拭子肺炎支原体DNA扩增试验阳性,肺部CT显示多发斑片密度增高影,肺炎支原体肺炎诊断成立。病程中患者同时伴发水疱疹、靶形疹和黏膜溃烂,结合肺炎支原体感染的实验室证据,支持RIME诊断。患者接受多西环素抗感染,短程、中等剂量的皮质类固醇联合免疫球蛋白治疗,痊愈出院。结论肺炎支原体感染引起的RIME可通过多西环素、皮质类固醇和免疫球蛋白治疗有效控制,预后良好。ObjectiveTo improve clinical understanding of reactive infectious skin and mucous membrane rash(RIME)caused by Mycoplasma pneumoniae infection,and to provide more accurate treatment and prognosis assessment for this disease.Methods A retrospective analysis was conducted on clinical data,treatment and prognosis of a patient with RIME caused by Mycoplasma pneumoniae infection,who was admitted to the Zhejiang University Sir Run Run Shaw Alaer Hospital,on April 11th,2024.ResultsThe 15-year-old female patient presented with symptoms indicative of fever,cough and mucosal ulceration.Subsequent laboratory investigations revealed the presence of positive serum IgM antibodies to Mycoplasma pneumoniae and a positive result for a Mycoplasma pneumoniae DNA amplification test conducted on throat swabs.Chest computed tomography(CT)scan revealed the presence of multiple patchy opacities,which were consistent with the imaging characteristics of Mycoplasma pneumoniae pneumonia.Throughout the clinical course,the patient exhibited a constellation of cutaneous lesions,including vesicular eruptions,targetoid lesions and mucocutaneous ulcerations.The diagnosis of RIME was supported by the combined evidence of laboratory findings indicative of a Mycoplasma pneumoniae infection.The patient was treated with doxycycline for its antibacterial properties,in conjunction with a brief course of moderate-dose corticosteroids and intravenous immunoglobulin therapy.This resulted in a complete recovery and subsequent discharge from the hospital.ConclusionsRIME caused by Mycoplasma pneumoniae infection can be effectively managed with doxycycline,corticosteroids and immunoglobulin therapy,with a favorable prognosis.

关 键 词：肺炎支原体 肺炎 皮疹 黏膜炎 

分 类 号：R563.1[医药卫生—呼吸系统]