Fatal Outcomes in Family Transmission of Mycoplasma pneumoniae
Fatal Outcomes in Family Transmission of Mycoplasma pneumoniae
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DOI：
10.1093/cid/cir769
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发表时间：
2012-01-15
影响因子：
11.8
通讯作者：
Baseman, J. B.
中科院分区：
文献类型：
--
作者：
Kannan, T. R.;Hardy, R. D.;Baseman, J. B.
肺炎支原体仍然是社区获得性肺炎的一个重要原因，并可表现为导致健康个体死亡的暴发性疾病。我们对2002年因呼吸衰竭和15岁的兄弟（兄弟姐妹1）和13岁的姐妹（兄弟姐妹2）死亡而被疾病控制和预防中心隔离的家庭成员进行了回顾性研究。使用一系列诊断测定法测试从死亡的兄弟姐妹收集的气道、脑脊液（CSF）和血清样品以及从父母和其余3个患病兄弟姐妹（兄弟姐妹3-5）收集的血清样品。同时对2号同胞的尸检肺组织标本进行免疫组化和免疫电镜检查。尸检评估同胞1显示脑水肿符合缺氧缺血性脑病和肺的发现闭塞性细支气管炎伴机化性肺炎（BOOP）。同胞2的尸检肺部检查显示淋巴浆细胞性细支气管炎伴管腔内脓性渗出物、BOOP和肺水肿。诊断分析结果提示M.肺炎在所有5个兄弟姐妹和父母双方。对同胞2的肺组织的进一步分析证实了M的存在。肺炎微生物和社区获得性呼吸窘迫综合征毒素。M.结论：从2例同胞尸检肺组织中直接培养肺炎克雷伯氏菌。有证据表明，M。肺炎很容易传播给家庭的所有成员，并且所产生的感染导致一系列个体反应，疾病进展不同，包括淋巴浆细胞性细支气管炎、BOOP和死亡。
Mycoplasma pneumoniae continues to be a significant cause of community-acquired pneumonia and can manifest as fulminant disease leading to mortality in healthy individuals.Methods. We conducted a retrospective study on members of a family who were quarantined by the Centers for Disease Control and Prevention in 2002 for respiratory failure and death of a 15-year-old brother (sibling 1) and a 13-year-old sister (sibling 2). Collected airway, cerebrospinal fluid (CSF), and serum samples from both deceased siblings and serum samples from both parents and the remaining 3 ill siblings (sibling 3-5) were tested using a range of diagnostic assays. Autopsy lung tissue samples from sibling 2 were also assessed using immunohistochemical and immunoelectron microscopic methods.Results. Autopsy evaluation of sibling 1 revealed cerebral edema consistent with hypoxic ischemic encepatholopathy and pulmonary findings of bronchiolitis obliterans with organizing pneumonia (BOOP). Postmortem lung examination of sibling 2 revealed lymphoplasmacytic bronchiolitis with intraluminal purulent exudate, BOOP, and pulmonary edema. Results of diagnostic assays implicated the household transmission of M. pneumoniae among all 5 siblings and both parents. Further analysis of lung tissue from sibling 2 demonstrated the presence of M. pneumoniae organisms and community-acquired respiratory distress syndrome toxin. M. pneumoniae was cultured directly from sibling 2 autopsy lung tissue.Conclusion. Evidence is provided that M. pneumoniae was readily transmitted to all members of the household and that the resulting infections led to a spectrum of individual responses with variation in disease progression, including lymphoplasmacytic bronchiolitis, BOOP, and death.