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目的分析新生儿肺炎衣原体(CPn)肺炎的临床表现及其影像学特征。方法收集9例CPn IgM抗体阳性患儿的临床资料,对9例CPn IgM抗体阳性的住院患儿的临床表现、胸部X线及胸部CT表现进行分析。结果 9例患儿中男6例,女3例。发病日龄8～27 d,平均18.2 d。发热6例,阵发性咳嗽6例,痉挛性咳嗽3例,呼吸增快5例,眼分泌物增多4例,发绀3例。肺部有湿啰音3例,6例无肺部阳性体征,仅胸片阳性。9例CPn IgM抗体均为阳性。肺炎支原体IgM抗体均为阴性。5例行纯化蛋白衍生物(PPD)试验结果均阴性。9例血培养及呼吸道分泌物细菌培养均阴性。流感病毒A、B型,副流感病毒1、2、3型,腺病毒及呼吸道合胞病毒抗体检测均阴性。6例胸部X线示两肺广泛性间实质性病变,弥散粟粒样影;CT影像表现为以小叶为中心的阴影,腺泡状阴影,气腔实变和小叶状分布的磨玻璃状阴影。结论新生儿CPn肺炎临床表现不典型,临床症状重,肺部体征较少,影像学改变明显,提示临床医师应注意CPn在新生儿的感染,使其得到及时有效的治疗,避免延误病情。
Objective To analyze the clinical manifestations and imaging features of neonatal pneumonia (CP) pneumonia. Methods The clinical data of 9 children with CPn IgM antibody were collected. The clinical manifestations, chest X - ray findings and chest CT findings of 9 CPn IgM antibody - positive inpatients were analyzed. Results There were 6 males and 3 females in 9 cases. The onset day of 8 ~ 27 d, an average of 18.2 d. 6 cases of fever, paroxysmal cough in 6 cases, spastic cough in 3 cases, 5 cases of rapid breathing, eye secretions increased in 4 cases, 3 cases of cyanosis. There were 3 cases of wet rales in the lungs, 6 cases had no pulmonary positive signs, and only the chest radiographs were positive. Nine cases of CPn IgM antibodies were positive. Mycoplasma pneumoniae IgM antibodies were negative. 5 routine purified protein derivative (PPD) test results were negative. Nine cases of blood culture and respiratory secretions bacterial culture were negative. Influenza A, B, parainfluenza viruses 1, 2 and 3, adenovirus and respiratory syncytial virus were all negative. 6 cases of chest X-ray showed extensive interstitial lung lesions, diffuse millet-like shadow; CT images showed lobular-centric shadows, alveolar shadows, air cavity consolidation and lobular distribution of ground-glass shadows. Conclusions The clinical manifestations of CPN pneumonia in infants are not typical, with severe clinical symptoms, less lung signs and obvious imaging changes. It suggests that clinicians should pay attention to the infection of CPn in neonates so that they can be treated promptly and effectively to avoid delay of the disease.