■冠状动脉扩张(CAD)很少被描述为除川崎病(KD)以外的高热疾病的心脏并发症。在肺炎支原体(MP)感染的患者中,有罕见的并发CAD病例。
■一名患有严重肺炎支原体肺炎(MPP)的6岁男孩在发病第11天因严重呼吸窘迫而被转移到我们医院。Nadroparin,左氧氟沙星,和甲基强的松龙,然后口服泼尼松是积极的规定。他的临床病情逐渐缓解,药物在第27天被撤回。遗憾的是,在没有感染中毒表现的情况下,反复发烧再次袭击了他。胸部CT发现坏死性肺炎(NP)。超声心动图显示右侧CAD(直径,3.40mm;z-score,3.8),然而,他的临床和实验室检查结果不符合KD的诊断标准.提出CAD是由MP感染引起的,阿司匹林是开的。令人鼓舞的是,一周后CAD回归(直径,2.50mm;z-score,1.4).此外,在开始泼尼松和Nadroparin治疗后7天,患儿死亡.患者最终在第50天出院。随访期间,患儿的超声心动图正常,胸部CT肺部病变完全消退.
■严重MP感染患者可发生CAD。儿科医生应警惕严重MP感染患者发生CAD的可能性,并认识到CAD也可能发生在高热疾病而不是KD中。
UNASSIGNED: Coronary artery dilation (CAD) had rarely been described as a cardiac complication of febrile disease other than Kawasaki disease (KD). There are rare cases complicated by CAD reported in patients with Mycoplasma pneumoniae (MP) infection.
UNASSIGNED: A 6-year-old boy with severe Mycoplasma pneumoniae pneumonia (MPP) was transferred to our hospital due to significant respiratory distress on the 11th day from disease onset. Nadroparin, levofloxacin, and methylprednisolone followed by oral prednisone were aggressively prescribed. His clinical condition gradually achieved remission, and the drugs were withdrawn on the 27th day. Regrettably, the recurrent fever attacked him again in the absence of infection-toxic manifestations. Necrotizing pneumonia (NP) was found on chest CT. And echocardiography revealed right CAD (diameter, 3.40mm; z-score, 3.8), however, his clinical and laboratory findings did not meet the diagnostic criteria of KD. CAD was proposed to result from MP infection, and aspirin was prescribed. Encouragingly, the CAD regressed one week later (diameter, 2.50mm; z-score, 1.4). Additionally, the child defervesced seven days after the initiation of prednisone and Nadroparin treatment. The patient was ultimately discharged home on the 50th day. During follow-up, the child was uneventful with normal echocardiography and fully resolved chest CT lung lesions.
UNASSIGNED: CAD can develop in patients with severe MP infection. Pediatricians should be alert to the possibility of CAD in patients with severe MP infection and recognize that CAD might also develop in febrile disease rather than KD.