Mycoplasma is the smallest extracellular microorganism that is a type of prokaryotic cell type microorganism that lacks a cell wall. The size is generally between 0.3 and 0.5um. It is highly polymorphic, with spherical, rod-shaped, filamentous, branched Like a variety of states.

　　It is different from cells and viruses. It has a wide variety, wide distribution, and great harm. It involves many fields such as humans, animals, plants, and insects. It brings human health and scientific research work. Negative Effects. Of the 16 species of Mycoplasma isolated from the human body, 5 are pathogenic to humans, namely Mycoplasma pneumoniae, Mycoplasma urealyticum, Mycoplasma hominis, Mycoplasma genitalium, and Mycoplasma urealyticum are Mycoplasma urealyticum, Ureaplasma urealyticum, etc. Mycoplasma hominis is pathogenic to humans.

　　 discovered that mycoplasma infection is a good thing, because we have a way to deal with it. However, how to accurately detect mycoplasma infection and reduce false positive detection is still the research direction, and there are still many debates.

　　In clinical practice, we have seen many hospital tests suggest that the child has a positive Mycoplasma infection, but the treatment effect according to Mycoplasma infection is not good. At this time, it is necessary to think, is the child really infected with mycoplasma? When you go to another hospital for re-examination, you will face two situations. One is the same as the outside hospital, and it is still positive. The other is negative.

A positive 　　 must be an infection, and a negative must deny that there is no infection?

　　False positive: refers to the result of detecting a person who does not have a positive symptom for various reasons.

　　 False negative: False negative means that the report is written as negative, but in fact this result is wrong, called false negative.

　　 Medicine has no absolute answer.

　　 From my limited clinical experience, I realized that the truth of chronic cough (the truth of the disease) is far from the point of mycoplasma infection. The family members of the children are used to staring at a point, the treatment effect of a case, and judging the treatment effect or level of the doctor. As a doctor, we are concerned about the incidence of a face, a probability, a cohort, and a population.

　　 has been paying attention to the treatment of chronic cough in children for about 5 years. In 2008, after following a professor''s subject in Shanghai, I understood that as a pediatrician, it is very important to follow up a child for a long time. Observed the fate of the disease, helped the child, and helped the doctor himself, and the experience has become more and more abundant.

　　Clinical experience is very important, laboratory tests are very important, and follow-up observation is more important.

　    First, the examination of mycoplasma antibodies is misleading.

　　 In recent years, mycoplasma infections have been called very loudly and also rumored to be very serious. If you pay attention, some hospital outpatients, even the so-called top three hospitals, the test is exaggerated, Nine of ten children are positive. If the pediatrician does not think about it, does not combine with the real situation of the child, and is only led by the nose to the test, then a considerable part of the child is misdiagnosed and over-treated.

　　There are data showing that after the human body is infected with Mycoplasma, its IgM antibody can last 6 months to 1 year in the blood, so the disappearance of IgM is not an indicator to judge the efficacy. On the contrary, the positive test in the hospital also It does not necessarily mean that the child has a recent infection.

　　Cough caused by mycoplasma infection is mixed with cough after asthma.

　　 Mycoplasma infections in children have very significant characteristics, more common in older children, especially children over 3 years old, less common within 1 year old; moderate fever, more body temperature At 38~39℃; irritating cough, severe, long duration, poor short-term treatment effect; occasionally induce wheezing.

　　Children with typical bronchial asthma, sometimes cough is also very intense, but at the same time There is wheezing, and some parents do not realize that the child is wheezing.On the one hand, they do not know what is called wheezing, only to find that the child seems to have a hissing sound in the throat or feel that the child always has a spitting sound; some children do It is not typical. The doctor can hear the end-expiratory wheezing only through the stethoscope.

　　 Of course, sometimes, children with asthma will also have mycoplasma infection at the same time, which is also very common.

　　Three, the illusion caused by the hormone-like effect of macrolide antibiotics.

After mycoplasma infection, many parents know that the use of penicillin or cephalosporin antibiotics is ineffective, and macrolide antibiotics (erythromycin or azithromycin, etc.) should be used. However, many parents, including individual doctors, do not know that macrolide antibiotics also have a hormone-like effect. As everyone knows, asthma should be treated with hormone drugs for inhalation, because hormones have functions such as asthma. Antibiotics have hormone-like effects, so it also has an asthma-relieving effect, but the effect is less than hormones. But it is this effect that makes some asthma children''s symptoms get some temporary relief, and the children''s asthma symptoms are alleviated, so Some parents mistakenly thought that the child’s mycoplasma infection was under control, but did not know that the child’s real cause was asthma.

　　Four, children with allergies often cough for a long time, and they are also prone to excessive use of azithromycin.

　　Children with allergies are very sensitive to airways. Regardless of the nature of the infection, cough will often be very violent. If you ignore allergic factors, ignore allergic treatment, blindly superstitious about antibiotics This is also the most common situation for parents. Many outpatient parents told me that every time a child has a cough after infection, no medicine can be used. Azithromycin is particularly effective. But my child''s mycoplasma infection test is negative, what is the situation? In fact, the steroid-like effect of azithromycin played a role.

　　Five, this hormone is not the other hormone hormone.

　　 hormones (glucocorticoids) are currently the most effective anti-inflammatory drugs for the treatment of asthma and allergies. This effect is related to its anti-inflammatory and anti-allergic effects. It can inhibit the production of prostaglandins and leukotrienes; reduce the production and response of inflammatory mediators; can make small blood vessels contract and reduce exudation. Glucocorticoids are an important rescue drug for persistent asthma or critical attacks. In recent years, the application of inhalation therapy has fully exerted the anti-inflammatory effect of glucocorticoids on the airway, and has also avoided systemic adverse reactions.

　　 Hormone-like effect is to have a hormone-like effect, not a hormone, not as many side effects as hormones. But it is an antibiotic, which is not good for long-term use.

When faced with mycoplasma infection, what should I do as a parent? My personal experience is for reference only.

　　 1. Mycoplasma antibody detection is the main test method for diagnosing mycoplasma infection, but it must be combined with the clinical characteristics of the child’s disease, and it is not possible to confirm the diagnosis of mycoplasma infection based on the positive antibody test alone. Yes or no, if it is true that the cough is obvious, the effect of the cough medicine is not good, the test result is positive or even negative, under the guidance of the doctor, use it boldly for three days, and then observe, so that you will not be entangled. For short-term use, the side effects are minimal.

　　 2. At the same time, we must continue to observe and think about it. Does the child cough for a long time, is there any reason that has nothing to do with mycoplasma? If the child does not get better after 3 to 5 days of treatment with mycoplasma, he needs to give the doctor timely feedback Treatment information, continue to observe and adjust the plan.

　　 3. If the child has allergic constitution, such as severe eczema as a child, repeated urticaria, allergic rhinitis, etc., if the child does not get better after a cold cough for more than a week or wheezing, it is highly suspected that cough and allergies Related, do not blindly eat antibiotics, you can add anti-allergy medicine under the guidance of a doctor.

　　4. Mycoplasma infections often have no tendency to recur. Macrolide antibiotics (such as azithromycin) treatment is sufficient for 2 to 3 weeks, and it is not continuous medication; eat 3 for 4 or 5 Stop 5 (Eat three days, four days or five days, five days, one treatment course no more than one week. Then use one of the methods provided above, listen to the doctor''s advice.) Do not extend the treatment time without permission, otherwise long-term medication will Bring a lot of side effects.

　　 5. During medication, pay attention to check the instructions. See if there are any side effects. Yesterday, a parent told me that the child had "tinnitus" after taking it once. I don’t know if it’s a side effect or a coincidence. Anyway, if you take the medicine once, your cough will be obviously better. Replace other antibiotics of the same kind, and no tinnitus will appear, but the tinnitus will disappear after the medicine is stopped. Let me judge the situation. I really can''t judge this case. The best way is that if you eat next time and have tinnitus again, you will highly suspect side effects. However, parents must be reluctant to experiment.