Objective To explore the clinical characteristics of Mycoplasma pneumoniae pneumonia (MPP) complicated with "top of the basilar" syndrome (TOBS) in children. Method The clinical data of MPP complicated with TOBS in a child were retrospectively analyzed, and the related literature was reviewed. Results A 6-year-old girl developed fever and inflexible movement in unilateral limb, and serum Mycoplasma pneumoniae antibody increased gradually. Lung CT showed a large area of inflammatory consolidation. Brain magnetic resonance imaging (MRI) showed multiple cerebral infarctions. After the symptomatic treatment of anti-infection, anticoagulation, thrombolysis and intracranial pressure reduction, the girl's condition continued to worsen and she presented with coma, cough weakness, dysphagia, facial nerve paralysis and bilateral pupillary inequality. Although the vital signs of the child were stable, she could not take care of herself and was still recovering. Conclusion MPP is often accompanied by hypercoagulative state and autoimmune abnormalities, and the prognosis of patients combined with TOBS is poor.%目的 探讨儿童肺炎支原体肺炎合并基底动脉尖综合征的临床特点.方法 回顾分析1例肺炎支原体肺炎合并基底动脉尖综合征患儿的临床资料, 并复习相关文献.结果 女性患儿, 6岁, 以发热、单侧肢体活动不灵活起病.血清肺炎支原体抗体逐次升高;肺部CT提示大片炎性实变;头颅MRI示多发性脑梗死.给予抗感染及抗凝、溶栓、降颅压等综合对症治疗后, 患儿病情仍进行性加重, 出现昏迷、咳嗽无力、吞咽困难、面神经麻痹、双瞳孔不等大.患儿虽生命体征平稳, 但生活不能自理, 仍在康复中.结论 肺炎支原体肺炎常伴有高凝状态及自身免疫异常, 并发基底动脉尖综合征者预后差.
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