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目的分析24例新生儿沙眼衣原体肺炎患儿相关临床资料,提高对新生儿沙眼衣原体肺炎的认识。方法应用实时荧光定量聚合酶链反应(PCR)检测2005年6月至2011年10月因肺炎收治复旦大学附属儿科医院新生儿科患儿呼吸道标本中的DNA,回顾性分析24例患儿的病史特点、临床表现、实验室检查、影像学特点、治疗及转归情况。结果新生儿沙眼衣原体肺炎主要表现为阵发性咳嗽、无热或低热、外周血嗜酸性粒细胞计数增高及X线胸片双肺广泛间质和(或)肺泡浸润,予红霉素或阿奇霉素治疗,均好转或治愈。初始误诊为肺结核5例,误诊率20.8%。结论新生儿衣原体肺炎无特异的临床及影像学表现,尤其是X线胸片易误诊为肺结核,应尽早行病原学检查,有利于及时诊治,减少并发症,红霉素或阿奇霉素是治疗衣原体肺炎有效的首选抗生素。
Objective To analyze the clinical data of 24 neonates with Chlamydia trachomatis pneumonia and to raise awareness of Chlamydia trachomatis pneumonia in neonates. Methods Real-time fluorescent quantitative polymerase chain reaction (PCR) was used to detect the DNA in respiratory specimens of neonates with pneumonia admitted to Pediatric Hospital of Fudan University from June 2005 to October 2011. The clinical features of 24 cases were retrospectively analyzed , Clinical manifestations, laboratory tests, imaging features, treatment and outcome. Results Chlamydia trachomatis neonatal pneumonia mainly manifested as paroxysmal cough, no fever or hypothermia, peripheral blood eosinophil count and lung extensive X-ray lung interstitial and (or) alveolar infiltration, to erythromycin or azithromycin Treatment, are improved or cured. Initial misdiagnosis of pulmonary tuberculosis in 5 cases, misdiagnosis rate of 20.8%. Conclusion Chlamydial pneumonia in neonates has no specific clinical and radiological manifestations. In particular, X-ray films are often misdiagnosed as pulmonary tuberculosis. Pathological examination should be conducted as soon as possible to facilitate diagnosis and treatment and reduce complications. Erythromycin or azithromycin is used to treat chlamydial pneumonia Effective first choice antibiotics.