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回顾性分析天津医科大学第二医院儿科2019年5月收治的肺炎支原体(MP)性胸腔积液1例。患儿，女，12岁，腹痛为首发症状，伴发热，以“消化道感染”对症治疗无缓解，入院前因出现呼吸困难结合查体及影像学检查发现胸腔积液，实验室检查支持MP感染，病程中始终缺乏明显肺部感染表现，经阿奇霉素联合美洛西林/舒巴坦抗感染治疗，疗效欠佳，改口服莫西沙星后体温平稳，口服糖皮质激素后胸腔积液迅速吸收，随诊6个月未再复发。提示儿童MP感染可导致胸膜炎及单侧胸腔积液，可以腹痛、发热为主要症状，常规大环内酯类抗菌药物耐药时可根据个体情况改为喹诺酮类治疗。“,”A case of Mycoplasma pneumoniae (MP) pleural effusion in the Department of Pediatrics, the Second Hospital of Tianjin Medical University at May 2019 was analyzed retrospectively.The female child was 12 years old, with abdominal pain as the onset of symptoms, accompanied by fever.“ Gastrointestinal tract infection” symptomatic treatment did not relieve it.Before being admitted to the hospital for dyspnea, combined with physical examination, imaging studies revealed pleural effusion.Laboratory tests supported MP infection, and the course of the disease always lacked obvious manifestations of pulmonary infection.The combination of Azithromycin and Meloxicillin/Sulbactam anti-infective treatment was ineffective, and the temperature was stable after changing to oral Moxifloxacin, and the pleural effusion was rapidly absorbed after oral glucocorticosteroids, without recurrence after 6 months of follow-up. It is suggested that MP infection in children can lead to pleurisy and unilateral pleural effusion, which can have abdominal pain and fever as the main symptoms, and can be changed to quinolones according to individual condition when conventional macrolides are resistant.