神经梅毒合并细菌感染一例

患儿男，32h．今年6月因发热、气促、脐部出血4h入院。患儿系G5P2，孕39周，家中分娩(由乡村医师接生)，无羊膜早破．羊水清亮，无窒息史。生后28h出现发热、气促、口吐白沫、无呻吟，伴脐带出血，渗透整个脐带包与部分裤子。抱至当地医院予重新包扎。患儿无抽搐及尖叫，查体：入院T38．5℃，R62次／min，HR158次／min，BP54／24     

新生儿麻疹合并肺炎二例

病例1，男，45min，因窒息复苏后气促45min入院。患儿有宫内窘迫史，剖宫产娩出，生后有窒息史，复苏后出现气促，以“新生儿窒息”收住院。母亲分娩时患有麻疹。入院查体：T36．0℃，R52次／min，体质量2．8kg，无皮疹，呼吸不规则，未见三凹征，双肺呼吸音粗，可闻及粗湿哕音，     

心下型肺静脉异位引流2例

例1，男，12天。出生时无窒息抢救史。生后第7天突然出现气促伴面色发绀。当地治疗2天无好转。生后第9天喂水时呛咳，气促、发绀加重。按肺炎心衰予利原强心后转送本院。其母孕3个月时曾患感冒。入院体检呼吸促，四肢及后周紫绀，心率172次／分，律齐，无杂音。双肺闻及细湿罗音，肝肋下3．5cm，质中，脾未及。四肢无殊。入院后即行气管插管接呼吸机通气。胸片示1．新生儿肺炎;2．心影左移，边缘不清，心影无扩大。超声心动图示完全性肺静脉异位引流（心下型）伴卵园孔未闭、三尖瓣反流。入院第4天行左右房吻合术。术中病理所见心脏大致正常…     

新生儿先天性膈疝1例误诊分析

患儿，男，5天，因生后气喘3天伴发热半天入院。系第二胎、第二产，足月顺产，无窒息史，生后第二天出现恶心，呕吐少许粘液，第三天出现气喘，吮乳减少，无呛咳史，入院当日上午发热，气喘加重、拒乳。体检：体温38．2C，脉搏110次／分，呼吸48次／分。生长发育正常，哭声可，面色微纣，四周青紫，皮肤粘膜无黄染，皮下无出血点及瘀斑。前囱平坦，瞳孔等大，对光反射存在，胸廓无畸形，可见轻度吸气性凹陷，双肺闻及散在湿音，右肺呼吸音稍低。心律齐，心音有力，腹平软、肝脾不大。拥抱反射存在，觅食反射未引出。拟诊：新生儿肺炎，败血…     

致病性大肠杆菌O_(119)B_(14)引起新生儿败血症肺炎出血性坏死性小肠炎致死一例

患儿,男,出生28小时,胎龄36周,顺产,生后无窒息,出生体重2250g。因生后口吐泡沫,以新生儿肺炎、早产儿入院。体检:体温33.5℃,呼吸48次,脉搏144次,头围30.5cm。未成熟儿貌。反应尚可,面色红润,口周青,轻度三凹征,前肉平。心音有力,心律整。肺呼吸音粗,腹软,脐无渗血,肝脾未发现异常。肠鸣音存在,新生儿生理反射存在,病理反射未引出。胸部X线摄片示两肺内带纹理粗重,散在小斑点状阴影,以右肺为著。实验室检查:血红蛋白21.5g,     

新生儿先天性肺囊肿一例

患儿，女，生后5min，以“新生儿轻度窒息、新生儿缺氧缺血性脑病？”收入院。患儿系孕41^＋6周出生前因胎儿宫内窘迫经剖宫产娩出，出生时1分钟阿氏评分7分（皮色、呼吸及肌张力各扣1分），轻度窒息，羊水Ⅲ度粪染。入院时查体：体温不升，心率128次／min，呼吸40次／min，反应尚可，足月儿外貌，面色稍红润、前囟平、双肺呼吸音粗糙、未闻及罗音，心音规则有力、律齐，各瓣膜听诊区均未闻及杂音、腹软，肝脾未触及肿大，肠呜音正常，新生儿反射可引出。     

重症金黄色葡萄球菌感染并双侧复发性重度气胸一例

患儿，男，4个月。因咳嗽1个月，加重伴发热2d以支气管肺炎收住院。患儿1个月前无明显诱因出现干咳。未做处理。入院前2d因受凉后咳嗽加重、气促，经外院门诊处理无效而入我院。入院查体：T39．3℃，R68次／min，HR150次／min。急性危重病容，精神差，面色差。口周发绀，轻度鼻翼扇动，咽充血。心率150次／min，律齐，心音有     

新生儿脾破裂1例

患儿,男,26 h,因哭闹烦躁5 h、反应差2 h由外院转入。患儿系足月顺产,无窒息史,生后即发现皮肤苍白,无发绀、抽搐、呕吐等,开奶后吃奶尚可,生后20 h余出现烦躁哭闹,于当地医院考虑颅内出血,予降颅压、止血药等对症处理,入院前2 h出现反应差,皮肤苍白加重,转入本院。入院查体:前囟平,反应差,肤色苍黄,无明显发绀,双肺未闻及湿音,心率140次/min,心律规整,心音低钝,腹稍膨隆、软,肠鸣音存在,肌张力低,新生儿反射减弱。血Hb 40 g/L,PLT、WBC正常,电解质基本正常,初步考虑颅内出血,行头颅CT检查未见大量出血,未抽出血性胃内容物,给予输血纠正…     

早产儿败血症合并指端坏疽1例报告

患儿,男,27d,孕29 3周产,因生后反应欠佳27d,伴呼吸暂停3d入院。系G4P2,因胎膜早破10h行剖宫产娩出,出生体重1350g,生后有轻度窒息史,先后按“早产儿窒息,肺炎”住当地医院治疗2次,近3d出现呼吸暂停,转我院。体查:T37.2℃,P150次/min,R50次/min,体重1400g,反应差,皮肤苍黄,前囟平软,可见轻度吸气性三凹征,双肺呼吸音粗糙,未闻及啰音,心音稍低,律齐,心率150次/min,肝肋下1cm,质软,双下肢轻度硬肿,四肢肌张力低,原始反射弱。入院诊断:早产儿,极低出生体重儿;贫血,新生儿肺炎;败血症。患儿入院后呼吸暂停较频繁,经鼻导管吸氧及输注压积红细胞…     

红霉素胸腔内注入治愈新生儿乳糜胸一例

红霉素胸腔内注入治愈新生儿乳糜胸一例吴秀静孙眉月患儿男，１４天。因气促２天入院。第一胎，足月剖腹产，无窒息及产伤史。出生体重４２５０ｇ。生后母乳喂养。体检：体温３７．５℃，脉搏１８０次／分，呼吸９０次／分，体重４４５０ｇ。烦躁，气促，口周发绀。心界右...     

Comparison of patients with Kawasaki disease with retropharyngeal edema and patients with retropharyngeal abscess

Kawasaki disease with retropharyngeal edema (KD with RPE) is a rare complication, and it is diagnosed by neck CT. Most reported cases had a delayed diagnosis because those patients' conditions were misdiagnosed as retropharyngeal abscess (RPA). The purpose of this study was to differentiate KD with RPE from RPA. We performed a retrospective case–control study comparing children with KD with RPE to those with RPA hospitalized at the tertiary pediatric hospital in Tokyo between 2005 and 2011. The 39 patients revealing RPE on neck CT were divided into two groups: group A was classified as KD (n?=?21) and group B was classified as non-KD (n?=?18). Patients in group B were finally evaluated as having RPA clinically and were treated with antibiotic therapy. A significantly higher proportion of patients in group B complained of dysphagia (11 patients vs. 5 patients; p?=?0.0170) and neck pain (17 patients vs. 12 patients; p?=?0.0106). Neck CT revealed a ring enhancement (16 patients vs. no patients; p?<?0.0001) and mass effect in a greater proportion of patients in group B (11 patients vs. 1 patient; p?<?0.0003). Conclusion: Careful attention to manifestations and close analyses of CT imaging may allow clinicians to differentiate KD with RPE from RPA.     

Patients with moyamoya disease presenting with movement disorder

Moyamoya disease is a rare cerebrovascular disease characterized by idiopathic bilateral stenosis or occlusion of bilateral internal carotid arteries and the development of characteristic leptomeningeal collateral vessels at the base of the brain. Typical presentations include transient ischemic attacks or stroke, and hemorrhage. Presentation with movement disorders is extremely rare, especially in the pediatric population. The authors describe the cases of 4 children with moyamoya disease who presented with movement disorders. Among 446 patients (118 pediatric) with moyamoya disease surgically treated by the senior author, 4 pediatric patients had presented with movement disorders. The clinical records, imaging studies, surgical details, and postoperative clinical and imaging data were retrospectively reviewed. The initial presenting symptom was movement disorder in all 4 patients: chorea in 2, hemiballismus in 1, and involuntary limb shaking in 1. All the patients had watershed infarcts involving the frontal subcortical region on MR imaging. Additionally, 1 patient had a ganglionic infarct. Single-photon emission computed tomography studies showed frontoparietal cortical and subcortical hypoperfusion in all patients. Three patients had bilateral disease, whereas 1 had unilateral disease. All the patients underwent superficial temporal artery-middle cerebral artery bypass. Postoperatively, all 4 patients had complete improvement in their symptoms. The SPECT scans revealed normal perfusion in 3 patients and a small residual perfusion deficit in 1. Movement disorders are a rare presenting feature of moyamoya disease. Hypoperfusion of the frontal cortical and subcortical region was seen in all patients, and the symptomatology was attributed to ischemic dysfunction and imbalance in the cortical-subcortical-ganglionic-thalamic-cortical circuitry. Combined revascularization with superficial temporal artery-middle cerebral artery bypass and encephaloduroarteriosynangiosis leads to excellent results.     

Treatment with probucol of children with familial hypercholesterolaemia

Nine children with familial hypercholesterolaemia, age range 2 to 12 years, were treated with a low cholesterol diet and probucol (10 mg/kg/day). The year before, the children received, as only treatment, a low fat-cholesterol diet. During this period their mean plasma total cholesterol level fell from 8.2 +/- 1.45 mmol/l to 7.17 +/- 0.84 mmol/l (12.6%). This level was further reduced to 5.92 +/- 0.63 mmol/l (17.1%) after the addition of probucol. Plasma high density lipoprotein cholesterol levels were lowered in absolute terms but not in relation to total cholesterol. No apparent side effects were observed. However, the use of probucol should be restricted for the moment to severe cases of hypercholesterolaemia as the long-term excretion of the drug in children is not yet known.