Mycoplasma pneumonia usually occurs 2 ~ 3 weeks after infection with Mycoplasma pneumoniae. Most children are in no hurry. 1/4 ~ 1/2, symptoms of upper respiratory tract infection such as stuffy nose, runny nose and sore throat, accompanied by moderate fever. The body temperature is about 39℃, and the heat type is uncertain. Most children cough frequently and violently. At first, it was a dry cough, and later it became a stubborn severe cough, sometimes pertussis-like cough, and later it coughed up more phlegm and occasionally bloodshot. No positive signs were found in the lungs during physical examination.
X-ray chest film shows obvious lung shadow, mostly unilateral lesions, mostly in the lower lobe, showing ground glass flake shadow, or patchy shadow scattered in the lung lobe.
Blood routine: white blood cells can be high or low, and most of them are normal.
ESR: faster.
Condensation test: positive.
In short, the characteristics of mycoplasma pneumonia are that the X-ray manifestations are inconsistent with the clinical signs, most of which are serious X-ray manifestations, while the lung signs are very slight, and even no positive signs are found.
Treatment:
The basis for diagnosis of mycoplasma pneumonia is as follows:
(1) persistent cough, frequent, no obvious positive signs in the lungs, but patchy or large shadows on X-ray examination, obvious X-ray lesions, which is the most important feature of this disease.
(2) The white blood cell count is mostly normal or slightly decreased.
(3) Penicillin, streptomycin and sulfanilamide are ineffective, while erythromycin can obviously relieve symptoms or shorten the course of disease.
(4) The titer of serum agglutination increased to over 65,438+0 ∶ 32, and the positive rate was 50% ~ 70%. Cold agglutinin appeared at the end of 65,438+0 after onset, peaked in 3-4 weeks, and disappeared in 2-4 months. But both bacteria (including tuberculosis) and virus infection are negative, so tuberculosis, bacterial and viral pneumonia can be ruled out.
(5) Isolation of pathogens: It takes more than 10 days to culture mycoplasma from sputum, nose and throat swabs of children, which has little clinical significance.
(6) The determination of serum specific antibodies, including fluorescent antibodies, complement fixation and hemagglutination inhibition, is helpful for diagnosis, but not as a routine examination.
Drug therapy:
Erythromycin or tetracycline is effective, but too much tetracycline taken by infants before the age of 8 can cause yellow-brown permanent teeth, and hypoplasia of deciduous teeth and permanent enamel is also common, which can even temporarily hinder bone growth and affect liver and kidney function. Therefore, erythromycin, 20 ~ 40 mg/kg daily, is the first choice for children to treat this disease, which can improve clinical symptoms, reduce lung shadow and shorten the course of disease. In severe cases, erythromycin can be added to 5% glucose intravenously at the concentration of 20 ~ 30 mg/kg per day, and the ratio of drug concentration to sugar concentration is1mg:1ml, and the dropping speed should be slow to avoid stimulating local blood vessels and causing phlebitis. Those who have obvious gastrointestinal reaction after using erythromycin can take digestive AIDS.
Home care:
Keep the indoor air fresh and provide digestible and nutritious food and enough liquid. Keep oral hygiene and respiratory tract unobstructed, often turn over, pat the back and change the patient's position, promote secretion discharge, and properly suck sputum when necessary to remove sticky secretions.