Objective: To explore the distribution characteristics of symptoms and signs of respiratory mycoplasma pneumoniae infection complicated with conjunctivitis in children of different age groups. Methods: A retrospective case series study was conducted. Data of children who were treated in Beijing Children's Hospital Affiliated to Capital Medical University from September 20, 2023 to November 30, 2023, had definite mycoplasma pneumoniae infection as confirmed by mycoplasma pneumoniae nucleic acid or mycoplasma pneumoniae IgM antibody test, and had conjunctivitis as the first diagnosis in ophthalmology department were continuously collected. The included children were divided into infant group (age<4 years), preschool group (age 4 to 6 years), and school-age group (age>6 years) for analysis. Information such as the time of ocular symptoms onset, the time of systemic symptoms onset, conjunctival sac secretion, subconjunctival hemorrhage, conjunctival congestion, corneal epithelial damage, co-infection with other pathogens, and treatment of all children was collected and compared among children of different age groups. Results: During this period, there were a total of 31 133 children with positive laboratory test results for mycoplasma pneumoniae. Among them, 835 children visited the ophthalmology department during the same period, and 124 cases (229 eyes) had conjunctivitis as the first diagnosis. The age was (5.43±2.83) years, including 72 males and 52 females. There were 37 cases (69 eyes) in the infant group, 48 cases (92 eyes) in the preschool group, and 39 cases (68 eyes) in the school-age group. Among the 229 eyes, 179 eyes (78.16%) had conjunctival secretion, all manifested as mucopurulent secretion; 12 eyes (5.24%) had corneal epithelial defect; and 26 eyes (11.35%) had subconjunctival hemorrhage. There was 1 eye (1.45%) with subconjunctival hemorrhage in the infant group, 16 eyes (17.39%) in the preschool group, and 9 eyes (13.24%) in the school-age group. The proportion of subconjunctival hemorrhage in the preschool group and school-age group was higher than that in the infant group (both P<0.05). Thirty-nine cases (31.45%) were found to have co-infection with viruses in laboratory tests, including influenza A virus, adenovirus, respiratory syncytial virus, and coxsackievirus. The proportion of children in all age groups with ocular symptoms first was higher than that with systemic symptoms first. There was no statistically significant difference among children in the three age groups in terms of whether there was conjunctival secretion, whether there was corneal epithelial damage, whether there was co-infection with viruses, and the interval between ocular symptoms and systemic symptoms onset (all P>0.05). Conclusions: The characteristic ocular manifestations of children with mycoplasma pneumoniae infection complicated with conjunctivitis are conjunctival congestion and subconjunctival hemorrhage, and the signs are more obvious in preschool children. The conjunctival sac secretion of such children with conjunctivitis is mostly manifested as mucopurulent. Ocular symptoms may be the first manifestation of mycoplasma pneumoniae infection.
目的： 探讨各年龄段儿童呼吸道肺炎支原体感染合并结膜炎的症状和体征分布特点。 方法： 回顾性病例系列研究。连续收集自2023年9月20日至11月30日于首都医科大学附属北京儿童医院就诊，经肺炎支原体核酸或肺炎支原体IgM抗体检查明确肺炎支原体感染，且在眼科就诊第一诊断为结膜炎的患儿资料，并将纳入的患儿按年龄分为婴幼儿组（年龄<4岁）、学龄前组（年龄4~6岁）及学龄期组（年龄>6岁）进行分析。收集所有患儿出现眼部症状时间、出现全身症状时间、结膜囊分泌物、结膜下出血、结膜充血、角膜上皮损伤，其他病原体合并感染及治疗等信息，并对不同年龄组患儿进行比较。 结果： 该时间段内肺炎支原体实验室检查结果为阳性的患儿共31 133例，其中同期在眼科就诊者835例，第一诊断为结膜炎者124例（229只眼），年龄为（5.43±2.83）岁，其中男性72例，女性52例。婴幼儿组37例（69只眼），学龄前组48例（92只眼），学龄期组39例（68只眼）。229只眼中有179只眼（78.16%）存在结膜分泌物，均表现为黏液脓性分泌物；12只眼（5.24%）有角膜上皮缺损；26只眼（11.35%）出现结膜下出血。结膜下出血婴幼儿组有1只眼（1.45%），学龄前组有16只眼（17.39%），学龄期组有9只眼（13.24%），学龄前组和学龄期组出现结膜下出血的比例均高于婴幼儿组（均P<0.05）。39例（31.45%）在实验室检查中发现合并病毒感染，包括甲型流感病毒、腺病毒、呼吸道合胞病毒、柯萨奇病毒。所有年龄段患儿先出现眼部症状比例均高于先出现全身症状的比例。3个年龄组患儿在是否有结膜分泌物、是否有角膜上皮损伤、是否合并病毒感染、眼部症状与全身症状出现的间隔时间上，差异均无统计学意义（均P>0.05）。 结论： 肺炎支原体感染合并结膜炎的患儿眼部特征性表现为结膜充血及结膜下出血，学龄前儿童体征更明显；这类结膜炎患儿的结膜囊分泌物多表现为黏液脓性；眼部症状可能成为肺炎支原体感染的首发症状。.