The child, 5 months old, was admitted to the hospital with “poor mental health with poor nasal function for 2 days”, with occasional light cough and no fever. The heart rate was 180 beats/minute, the heart rhythm was uniform, no pathological murmur was detected, the abdomen was slightly distended, no mass, and the neurological examination was negative. Auxiliary examinations.
After admission, he was treated with CPAP, meropenem combined with vancomycin for anti-infection and closed drainage of the chest cavity. The effusion was significantly reduced. But this child is strange, there has been no fever and cough, no obvious symptoms of infection and poisoning. He is still under treatment and TSPOT was done during this period, weak response. Please give your opinion.
All discussion.
medical practitioner ping
Genetic sequencing suggests that it is Bacillus cereus, but the amount is very small. So not sure if it is. But after the above treatment the effusion was significantly reduced and the condition improved. However, a few days ago a repeat CT suggested fluid encapsulation and was transferred to a higher hospital.
zgchj18
Mycoplasma pneumoniae infection is an inflammatory response in the lungs caused by an overwhelming immune response.
The child’s complaints are not coughing, indicating that the infection is not the process from the oropharynx to the bronchus and then to the lungs, but from the beginning in the lungs fixed value, the immune response is too strong in the local inflammatory response, until there is a respiratory effort, as well as other discomfort to pay attention to, sometimes the clinic is not careful physical examination, often ignoring the condition, chest X-ray, wow, are pleural effusion.
This is not uncommon in clinical practice. Although the child has such a heavy inflammation of the lungs, because of the non-bacterial infection caused, in addition to slightly high white blood cells, such as neutrophils, crp, esr, especially PCT is not high.
Of course, in the course of treatment, bacterial, tuberculosis, and tumorigenic etc. causes need to be excluded.
Macrolide treatment should be effective.
The macrolides were not used in the treatment, and after treatment, the cell count of the effusion has been reduced to a few dozens, and the volume of the effusion has been significantly reduced
zgchj18
Mycoplasma pneumoniae infection is an inflammatory response in the lungs caused by an overwhelming immune response.
The child’s complaints are not coughing, indicating that the infection is not the process from the oropharynx to the bronchus and then to the lungs, but from the beginning in the lungs fixed value, the immune response is too strong in the local cause inflammatory reaction, until there is breathing effort, as well as other discomfort to pay attention to, sometimes the clinic does not carefully physical examination, often ignore the condition, chest X-ray a look, wow, are pleural effusion.
This is not uncommon in clinical practice. Although the child has such a heavy inflammation of the lungs, because of the non-bacterial infection caused, in addition to slightly high white blood cells, such as neutrophils, crp, esr, especially PCT is not high.
Of course, in the course of treatment, bacterial, tuberculosis, and tumorigenic etc. causes need to be excluded.
The effect of macrolide treatment should be good.
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