儿童常见病原体所致社区获得性肺炎胸部X射线摄片影像学表现

doi:10.3877/cma.j.issn.1673-5250.2022.01.002

社区获得性肺炎(CAP)是导致<5岁儿童死亡的主要原因之一，对家庭及社会均造成较大疾病负担。儿童CAP病原体构成多样，流行病学、易感人群、临床及影像学表现各异。胸部X射线摄片(CR)对辅助诊断儿童CAP，具有经济、快速、利于动态监测等优势。笔者拟就病毒性[呼吸道合胞病毒(RSV)、腺病毒、流行性感冒(Flu)病毒、副流行性感冒病毒(PIV)]，细菌性[肺炎链球菌(SP)、金黄色葡萄球菌(SA)、流行性感冒嗜血杆菌(HI)、大肠埃希菌(EC)、肺炎克雷伯菌(KP)、铜绿假单胞菌(PA)]及非典型性[肺炎支原体(MP)、肺炎衣原体(CP)、嗜肺军团菌(LP)] 3类儿童CAP的临床特点及其CR特点的最新研究进展进行阐述，旨在为临床辅助诊断不同病原体感染所致CAP及其早期治疗提供参考，并且对CR诊治常见病原体感染所致CAP患儿的临床前景进行展望。

关键词: 肺炎，病毒性, 肺炎，细菌性, 社区获得性肺炎, 非典型病原体, 胸部X射线摄片, X线影像增强, 呼吸道合胞病毒, 儿童

Community-acquired pneumonia (CAP) is one of the most important causes of death in children younger than 5 years old, which contributes large disease burden to both families and society. Multiple pathogens of CAP cause different characteristics in epidemiology, susceptible population, clinical and imaging manifestations. With high diagnostic value in CAP, chest radiography(CR) is cost-efficient and rapid, which can monitor dynamically. The author intends to expound the latest research progresses of clinical characteristics and CR imaging features of children with CAP caused by three kinds of pathogens: ①viruses as causes of CAP including respiratory syncytial virus (RSV), adenovirus, influenza (Flu), and parainfluenza viruse (PIV); ②bacteria as causes of CAP including Streptococcus pneumoniae (SP), Staphylococcus aureus (SA), Haemophilus influenzae (HI), Escherichia coli (EC), Klebsiella pneumoniae (KP), Pseudomonas aeruginosa (PA); ③ atypical pathogens as causes of CAP including Mycoplasma pneumoniae (MP), Chlamydia pneumoniae (CP), Legionella pneumophila (LP), in order to provide reference for clinical auxiliary diagnosis and early treatment, and to look forward to clinical prospect of CR in diagnosis and treatment of different types of CAP.

Key words: Pneumonia, viral, Pneumonia, bacterial, Community-acquired pneumonia, Atypical pathogens, Chest X-ray, Radiographic image enhancement, Respiratory syncytial viruses, Child

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Chest radiography imaging manifestations of children with community-acquired pneumonia caused by common pathogens

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Chest radiography imaging manifestations of children with community-acquired pneumonia caused by common pathogens