张增平;陈瑞琴;陈仕珠;

• 1:苏州明基医院神经内科
• 2:苏州大学附属瑞华医院儿科
• 3:西安市解放军第451医院感染科

摘要(Abstract)：

随着世界范围肺炎支原体(Mp)感染发病率快速增加,Mp感染引起神经系统损害的发生率亦随之增加,儿童多见。Mp感染引起的中枢神经系统病变包括脑炎、脑膜炎、脑脊髓膜炎、弥漫性脑膜炎等非化脓性脑膜炎、多发性神经病变、急性炎症性脱髓鞘性多发性神经病变综合征,可逆性神经病变综合征及多种外周神经病变/损害。诊断依赖血清学(抗MpIgM阳性)或组织免疫组化检查。治疗首选大环内酯(Ma)类药物,对Mp感染引起的顽固性神经系统损害患儿联用强的松或免疫球蛋白比单用Ma效佳;对耐Ma Mp(MaRMp)株感染选用敏感Ma或换用或直接应用作用强大的二甲胺四环素、加雷沙星等。

关键词(KeyWords)： 肺炎支原体;神经系统病变;脑炎;大环内酯;二甲胺四环素

Abstract:

Keywords:

基金项目(Foundation): 苏州市“科教兴卫”青年科技项目(KJXW2016065)

作者(Authors): 张增平;陈瑞琴;陈仕珠;

参考文献(References)：

• [1]陈瑞琴,张增平,陈仕珠.耐大环内酯肺炎支原体感染的研究进展[J].国际儿科学杂志,2014,4(6):614-617.
• [2]Dutow P,Schmidl SR,Ridderbusch M,et al.Interactions between Glycolytic Enzymes of Mycoplasma pneumoniae[J].J Molecul Microbil Biotechnol,2010,19(3):134-139.
• [3]Liong T,Lee KL,Poon YS,et al.Extrapulmonary involvement associated with Mycoplasma pneumoniae infection[J].Hong Kong Med J,2015,21(6):569-572.
• [4]陈仕珠,张增平,任菊香,等.以神经系统症状为主要表现的肺炎支原体感染诊断和治疗[J].中华临床医师杂志,2012,6(18):5 708-5 710.
• [5]Beauchamp DJ,da Costa RC,Premanandan C,et al.Mycoplasma felis-associated meningoencephalomyelitis in a cat[J].J Feline Med Surgery,2011,13(2):139-143.
• [6]Srensen CM,Schnning K,Rosenfeldt V.Clinical characteristics of children with Mycoplasma pneumoniae infection hospitalized during the Danish 2010-2012epidemic[J].Dan Med J,2013,60(5):A4 632.
• [7]Yin Y,Lu Q,Yan XL.Epidemiology of Mycoplasma Pneumoniae infections[J].Zhonghua er ke za zhi.Chinesejoernalofpediatrics,2016,54(2):91-93.
• [8]Zhao H,Li S,Cao L,et al.Surveillance of Mycoplasma pneumoniae infection among children in Beijing from2007to 2012[J].Chin Med J(Engl),2014,127(7):1244-1 248.
• [9]Panagariya A,Sharma AK,Dev A,et al.Reversible neurological syndromes with atypical pneumonia[J].Annal India Academy Neur,2011,14(2):127-129.
• [10]Hu CF,Wang CC,Chen SJ,et al.Prognostic values of a combination of intervals between respiratory illness and onset of neurological symptoms and elevated serum IgM titers in Mycoplasma pneumoniae encephalopathy[J].J Microbiol Immunol Infect,2014,47(6):497-502.
• [11]EL Hafidi N,Allouch B,Benbrahim F,et al.Mycoplasma pneumoniae encephalitis associated with basal ganglia necrosis[J].Revue eurologique,2012,168(1):49-52.
• [12]Powers JM,Johnson MD.Mycoplasma panencephalitis:a neuropathologic documentation[J].Acta Neuropathologiic,2012,124(1):143-148.
• [13]Schmucker RD,Ehret A,Marshall GS.Cerebellitis and acute obstructive hydrocephalus associated with Mycoplasma pneumoniae infection[J].Pediatr Infect Dis J,2014,33(5):529-532.
• [14]Hanzawav F.A 3-year-old boy with Guillain-Barrésyndrome and encephalitis associated with Mycoplasma pneumoniae infection[J].J Infect Chemother,2014,20(2):134-138.
• [15]Izumikawa K,Takazono T,Kosai K,et al.A 3-year-old boy with Guillain-Barrésyndrome and encephalitis associated with Mycoplasma pneumoniae infection[J].J Infect Chemother,2014,20(2):134-138.
• [16]Makonahalli R1,Seneviratne J,Seneviratne U.Acute small fiber neuropathy following Mycoplasma infection:a rare variant of Guillain-Barrésyndrome[J].J Clin Neuromuscul Dis,2014,15(4):147-151.
• [17]L31-3Simpkins A,Strickland SM,Oliver J,et al.Complete resolution of advanced Mycoplasmaencephalitis mimicking brain mass lesions:Report of two pediatric cases and review of literature[J].Neuropathology,2012,32(1):91-99.
• [18]Rappoport D1,Goldenberg-Cohen N,Luckman J,et al.Parainfectious optic neuritis:manifestations in children vs adults[J].J Neuroophthalmol,2014,34(2):122-129.
• [19]Bae JW,Kim HJ,Chang GY,et al.Combined Striatum,Brain Stem,and Optic Nerve Involvement due to Mycoplasma pneumoniae in an Ambulatory Child[J].Case Report Neurology,2011,3(2):109-112.
• [20]Chiang WY,Huang HM.Bilateral monosymptomatic optic neuritis following Mycoplasma pneumoniae infection:a case report and literature review[J].Indian J Ophthalmol,2014,62(6):724-727.
• [21]Kong M,Jiang L,Hu J,et al.Clinical characteristics of Mycoplasma pneumoniae-associated ischemic stroke in children,and a literature review[J].Zhong guo Dang Dai Er Ke Za Zhi,2012,4(11):823-882.
• [22]Garcia AV,Fingeret AL,Thirumoorthi AS,et al.Severe Mycoplasma pneumoniae infection requiringextracorporeal membrane oxygenation with concomitant ischemic stroke in a child[J].Pediatr Pulmonol,2013,48(1):98-101.
• [23]Tay CG,Fong CY,Ong LC.Transient parkinsonism following mycoplasma pneumoniae infection with normal brain magnetic resonance imaging(MRI)[J].J Child Neurol,2014,29(12):193-195.
• [24]Butin M,LabbéG,Vrielynck S,et al.Late onset Ondine syndrome:literature review on a case report[J].Arch Pediatr,2012,19(11):1 205-1 207.
• [25]Rhodes RH,Monastersky BT,Tyagi R,et al.Mycoplasmal cerebral vasculopathy in a lymphoma patient:Presumptive evidence of Mycoplasma pneumoniae microvascular endothelial cell invasion in a brain biopsy[J].J Neurological Sci,2011,309(1/2):18-25.
• [26]Sugeno N,Kawaguchi N,Hasegawa T,et al.A case with anti-galactocerebroside ntibody-positive Mycoplasma pneumoniae meningoencephalitis presenting secondary hypersomnia[J].Neurol Sci,2012,33(6):1 473-1 476.
• [27]Sobieszczańska BM,Kasprzykowska U,Duda-Madej A,et al.Relevance of serology for Mycoplasma pneumoniae infection among children with persistent cough[J].Adv Clin ExpMed,2014,23(2):185-190.
• [28]Zhang HL,Chen HZ,Zheng YJ.The diagnosis of Mycoplasma pneumoniae infections[J].Zhonghua er ke za zhi.Chinesejoernal of pediatrics,2016,54(2):98-100.
• [29]Lu Y,Zhang H.Clinical microbiology of Mycoplasma pneumoniae[J].Zhonghua er ke za zhi.Chinesejoernal of pediatrics,2016,54(2):88-90.
• [30]Zhou YL,Zhang YY,Sheng YJ,et al.More Complications Occur in Macrolide-Resistant than in Macrolide-Sensitive Mycoplasma pneumoniae Pneumonia[J].Antimicrob Agents Chemother,2014,58(2):1 034-1 038.
• [31]Tagliabue C,Techasaensiri C,Torres JP,et al.Efficacy of increasing dosages of clarithromycin for treatment of experimental Mycoplasma pneumoniae pneumonia[J].J Antimicrobil Chemotherapy,2011,66(10):2 323-2 329.
• [32]Koga S,Ishiwada N,Honda Y,et al.A case of meningoencephalitis associated with macrolide-resistant Mycoplasma pneumoniae infection[J].Pediatr Int,2012,54(5):724-726.
• [33]Ficko C,Andriamanantena D,Mangouka L,et al.Mycoplasma pneumoniae encephalitis successfully treated by levofloxacin[J].Rev Med Interne,2015,36(1):47-50.
• [34]Seo YH,Kim JS,Seo SC,et al.Predictive value of C-reactive protein in response to macrolides in children with macrolide-resistant Mycoplasma pneumoniae pneumonia[J].Korean J Pediatr,2014,57(4):186-192.