摘要
目的阐述儿童肺炎链球菌相关溶血尿毒综合征的临床表现、诊断及治疗方法。方法回顾性分析1例儿童肺炎链球菌相关溶血尿毒综合征患儿的临床表现、实验室检验、影像学检查、治疗经过及随访结果,并以“肺炎链球菌相关溶血尿毒综合征”“Streptococcus pneumoniae-associated hemolytic-uremic syndrome”作为关键词检索国内外文献并进行复习。结果患儿为男性,3岁零5个月,以发热、咳嗽起病,有肺炎合并脓胸、胸腔积液,胸腔积液行肺炎链球菌抗原检测为阳性,胸腔积液行第二代测序结果为肺炎链球菌,行血浆置换治疗病情好转,3 d内血小板恢复,血尿素氮及肌酐水平在8 d内恢复正常。随访3个月,病情稳定,无肾脏损害表现。结论儿童重症肺炎合并胸腔积液患者当出现急性溶血性贫血、急性肾衰竭、血小板下降等表现时,应考虑到肺炎链球菌相关溶血尿毒综合征的可能,一旦确诊,应及时采用血浆置换治疗,效果显著,预后良好。
Objective To summarize the clinical characteristics of hemolytic uremic syndrome associated with Streptococcus pneumoniae in children.Methods The clinical manifestations,imaging and laboratory findings,treatment experience and follow-up of a case of Streptococcus pneumoniae-associated hemolytic uremic syndrome(SpHUS)in children were retrospectively analyzed,and the literatures at home and abroad were retrieved by using the key words"Streptococcus pneumoniae-associated hemolytic uremic syndrome".Results The patient was a 3-year-and 5-month-old boy,suffered from pneumonia complicated with empyema and pleural effusion.The detection of Streptococcus pneumoniae antigen in pleural effusion was positive.The next generation sequence result of pleural effusion was Streptococcus pneumoniae.Plasma exchange treatment was performed,and the condition was rapidly improved.Platelets recovered within 3 days,and blood urea nitrogen and creatinine levels returned to baseline within 8 days.The patient has been followed up for 3 months,and his condition is stable without renal damage.Conclusion Once severe pneumonia children with pleural effusion develops acute hemolytic anemia,acute renal failure,thrombocytopenia and other manifestations,our clinicians should consider the possibility of SpHUS.Plasma exchange is effective in the treatment of SpHUS with good prognosis.
作者
禹定乐
李莉
陈杰华
李雨铮
郑跃杰
王文建
YU Ding-le;LI Li;CHEN Jie-hua;LI Yu-zheng;ZHENG Yue-jie;WANG Wen-jian(Department of Respiratory,Shenzhen Children's Hospital,Shenzhen,Guangdong 518038,China;不详)
出处
《中国微生态学杂志》
CAS
CSCD
2022年第5期553-556,共4页
Chinese Journal of Microecology
基金
深圳市医疗卫生三名工程项目(SZSM201512030)
深圳市医学重点学科建设经费(SZXK032)。
