Mycoplasma pneumoniae pneumonia coinfected with hypermastigote in 18 children / 中华实用儿科临床杂志

ABSTRACT

Objective To explore the clinical manifestations of hypermastigote detected from bronchoalveolar lavage fluid in children with mycoplasma pneumoniae pneumonia (MPP).Methods The clinical data from 18 cases (7 male cases,11 female cases;the age raged from 5 months to 13 years;13 case lived in rural cottage,5 cases lived in town building;the course ranged from 2 to 60 days) of MPP coinfected with hypermastigote were retrospectively analyzed,including the symptomatic and physical examination data, laboratory test, chest imaging features, bronchoscopic manifestation imaging,treatment and prognosis.The clinical characteristics and treatment of MPP coinfected with hypermastigote were analyzed.Results Clinical symptoms showed that 18 cases had cough, 14 cases had fever and 4 cases had asthma;laboratory blood routine test detected that 13 cases had increased leukocytes,5 cases with increased eosinophils;11 cases with increased C reactive protein and 8 cases with increased erythrocyte sedimentation rate.Eleven of 18 cases received immunological examination,which showed that 3 cases had increased IgG,2 cases with increased IgM,5 cases with increased IgA,and 11 cases with decreased ratio of CD4 and CD8;bronchoalveolar lavage fluid test showed that 1 case had increased eosinophils and hypermastigote were detected in 18 cases.High density spotty shadow were seen in chest imaging.Mucosal congestion, attached with white sputamentum, longitudinal folds, floc floating and sputum bolt obstructing within the lumen were seen under the bronchoscopy.The macrolides antibiotics combined with metronidazole (5 cases received metronidazole lung lavage) were effective.Conclusions Hypermastigote is a new type pathogen isolated from the lower respiratory tract in Liaocheng.For patients with MPP who have unsatisfactory response, hypermastigote should be taken into account and combined with metronidazole in therapy for better effect.