2005年至2009年苏州地区儿童流行性感冒住院病例临床特征的回顾性分析

目的 分析苏州地区儿童流行性感冒(流感)住院病例的临床特征.方法 回顾性调查苏州大学附属儿童医院流感住院患儿的人口学资料、实验室诊断、临床特征、治疗和结局等,数据行x2检验、趋势检验.结果 2005年至2009年共有480例经实验室确证的流感住院患儿,其中A型414例,B型66例,平均流感病毒阳性检出率为2.66%;≤5岁患儿为419例,占87.29%;冬季(12月至次年4月)和夏季(7月至8月)发病占大多数;各年度流感住院患儿年龄、性别分布差异无统计学意义(x2=9.7768,x2=8.7573;均P＞0.05).流感住院病例的平均病程为(16.22±9.41)d,平均住院时间为(7.89±2.97)d,发热、呼吸困难、腹泻、需吸氧等临床特征均有随年龄上升而下降的趋势(Z=4.9430,Z=2.1021,Z=3.2073,Z=2.3277;均P＜0.05),肺炎、上呼吸道感染等临床诊断也有随年龄上升而下降的趋势(Z=-3.8762,Z=-3.5095;均P＜0.01).15.5%(60/387例)流感病例合并肺炎链球菌感染,15.0%(72/480例)合并呼吸道合胞病毒(RSV)感染,合并细菌感染儿童的C反应蛋白水平显著高于合并病毒感染者(Z=-3.1290,P＜0.01).结论 苏州地区儿童流感住院病例呈现季节性分布,与肺炎链球菌及RSV混合感染现象较常见,且低年龄组儿童的临床症状较严重.     

165例住院儿童甲型流感病毒肺炎及混合感染的临床特征

目的 分析儿童甲型流感病毒肺炎感染及混合感染的临床特征。方法 回顾性分析2019年12月至2021年12月在苏州大学附属儿童医院住院的165例儿童甲型流感病毒肺炎的临床资料，根据是否混合其它病原菌分为混合感染组(111例)和非混合感染组(54例)。结果 儿童甲型流感病毒肺炎呈季节性流行，冬春季节多见。主要临床表现为发热、咳嗽、消化道等症状。混合感染组消化道症状多于非混合感染组(P<0.05),两组性别、年龄、高热、咳嗽、呼吸困难、惊厥及合并其它呼吸系统、神经系统、循环系统、多器官功能损害、电解质紊乱、中耳炎并发症差异无统计学意义。非混合感染组发生白细胞降低多于混合感染组，C-反应蛋白、乳酸脱氢酶升高者混合感染组多于非混合感染组(P均<0.05)。165例儿童混合感染率67.27%,检出细菌阳性率44.24%(肺炎链球菌及流感嗜血杆菌多见),其次为肺炎支原体、病毒。经治疗96.36%患儿痊愈出院，并发严重并发症的6例儿童均混合其它病原菌感染，其中4例有基础疾病。混合感染组住院时间长于非混合感染组，住院费用高于非混合感染组(P均<0.05)。结论 儿童甲型流感病毒肺炎易混...     

婴幼儿结核性脑膜炎12例误诊分析

一、临床资料1.一般资料:本组12例,年龄1个月～3岁,误诊为上感、化脓性脑膜炎、病毒性脑炎各2例,支气管肺炎、小儿肠炎、高热惊厥、乙脑、低钙惊厥、原发性癫痫各1例。病前曾接种卡介苗者3例,有明确结核接触史者6例。症状及体征:发热11例,嗜睡6例,激惹6例,头痛3例,呕吐8例,抽搐6例,昏迷2例,肢体瘫痪1例,大小便     

儿童流感疫苗接种的那些事

流感是流感病毒引起的一种急性呼吸道传染病,严重危害人群健康.5岁以下儿童作为流感的高危人群,罹患流感后出现严重疾病和死亡的风险较高.目前处于流感病毒流行的冬季,在新冠肺炎疫情流行态势仍在持续的情况下,儿童将面临新冠病毒及流感病毒感染的双重风险.因此,接种流感疫苗预防流感显得尤为必要.     

儿童甲型H1N1流行性感冒病毒相关性肺炎的临床特征

目的 了解儿童甲型H1N1流行性感冒(流感)病毒相关性肺炎的临床流行特征.方法 通过描述性研究对2009年上海复旦大学附属儿科医院收治的30例甲型H1N1流感病毒所致肺炎的患儿做临床及流行病学分析.中位数比较采用秩和检验,率的比较采用精确卡方检验.结果 30例确诊为甲型H1N1流感合并肺炎的患儿中,年龄中位数为5.9岁,5例有基础疾病史,占16.7%.有明确发热病例暴露史的20例,占66.7%.所有患儿均有发热和咳嗽,11例伴气促,占36.7%,10例伴喘息,占33.3%.11例患儿WBC＜4.0×109/L,占36.7%,2例PLT减少,占6.7%.所有患儿入院时胸部X线片提示肺部有单侧或双侧片状渗出性病灶,4例危重症患儿肺部多处大片状渗出伴肺水肿,占13.3%,1例危重症肺炎患儿发病后3个月和9个月复查胸部CT提示不同程度肺纤维化,占3.3%,3例同时伴纵隔积气和皮下积气,占10.0%,6例并发急性呼吸衰竭,占20.0%,3例伴支气管哮喘急性发作,占10.0%,1例合并脑炎,占3.3%.所有患儿均给予奥司他书和抗菌药物治疗,4例接受机械通气,均治愈或好转出院.发病2 d内和2 d后接受奥司他韦治疗的患儿的热程中位数比较差异有统计学意义(2 d比5 d,Z=-8.015,P＜0.01).结论 学龄前和学龄儿童易感染甲型H1N1流感病毒,可并发严重的肺部疾病.在发病早期采用奥司他韦治疗,可缩短热程,降低危重并发症的发生.     

甲型H1N1流感45例临床分析

目的探讨甲型H1N1流感的流行病学及临床特点。方法总结分析45例甲型H1N1流感的流行病学和临床资料。结果 45例发病主要集中在9月至次年3月,均系本地发病,年龄10~64岁之间,其中中小学生32例（71%）,住院8例（18%）,住院患者年龄24-64岁之间,平均年龄52岁,有基础病COPD 1例,糖尿病2例,并发肺部感染6例,重症1例,重危1例,住院天数4-15 d,平均11 d,均治愈出院。结论甲型H1N1流感人群普遍易感,学校易集中发病,重危病人多为老年合并基础病变的患者。早发现、早隔离、早诊断、早期给予神经氨酸酶抑制剂进行抗病毒治疗,疗效满意。     

儿科住院患者流感病毒合并革兰阳性菌感染临床特征与危险因素分析

目的 研究住院患儿流感病毒合并不同类型革兰阳性菌感染的临床特点以及危险因素,为临床治疗提供参考。方法 回顾分析2014年1月-2019年1月本院住院的流感病毒合并革兰阳性菌(G⁺)感染患儿的临床资料,共110例,以其为研究组;抽选同期住院的110例未合并G⁺感染的流感病毒感染患儿为对照组,应用独立样本t检验法以及Fisher检验以及χ²检验方法分析入组患儿的临床资料,并应用多因素Logistic回归分析法分析流感病毒合并G⁺感染的危险因素。结果 研究组中,甲型与乙型流感病毒感染分别为75例、35例,其中合并A群链球菌感染10例,合并金黄色葡萄球菌感染7例,合并肺炎链球菌感染93例;16例患儿存在基础性疾病,110例患儿均未接种肺炎球菌疫苗且仅有1例在1年内接种流感疫苗;对照组中,甲流感染79例,乙流感染31例,5例基础性疾病,7例接种过肺炎球菌疫苗,13例在入组前1年内接种过流感疫苗。两组患儿临床特征比较,研究组患儿年龄小[(2.46±1.79)岁vs (5.01±2.44)岁,t=-7.436,P...     

2020年6月—2023年4月临沂地区儿童流感流行病学及甲型流感临床特征

目的 分析2020年6月—2023年4月临沂地区儿童流感流行病学及甲型流感临床特征。方法 收集2020年6月—2023年4月临沂市妇幼保健院儿科急诊及发热门诊就诊的流感样症状儿童鼻咽拭子标本6 651份，采用多重实时荧光PCR方法进行流感病毒检测与分型鉴定；同时记录患儿性别、年龄、发病时间、症状，并后续于电子病历系统中调取患儿实验室与影像学检查等临床资料。结果 6 651份儿童咽拭子标本中，流感阳性1 298例（19.52%），其中甲型流感1 015例（78.20%）、乙型流感283例（21.80%）。2020年6月—2021年5月、2021年6月—2022年5月、2022年6月—2023年4月流感阳性例数分别为24例（2.96%）、275例（10.50%）、999例（31.03%），各年度比较，P均<0.05。男性及女性流感阳性例数分别为785例（19.91%）、513例（18.94%），两性别比较，P>0.05。≥1岁者、1～3岁者、4～6岁者、7～14岁者流感阳性例数分别为172例（7.08%）、469例（22.04%）、466例（31.96%）、191例（30.08...     

2022年1—12月咸阳市某儿童医院住院儿童肺炎链球菌感染的流行病学及临床特点

目的 总结2022年1—12月咸阳市某儿童医院住院儿童肺炎链球菌（SP）感染的流行病学特点及临床特点，为SP感染的早期诊断提供参考。方法 选取2022年1—12月咸阳市儿童医院住院的SP感染患儿423例。收集SP感染患儿的年龄、性别、住院时间及合并感染情况，总结患儿SP感染流行病学特点。收集患儿临床症状、影像学检查结果及血液生化结果，同时与非SP感染肺炎患儿比较血液生化结果，总结患儿SP感染的临床特点。结果 不同年龄段、性别及季节之间SP感染率比较，P均>0.05;SP感染患儿合并感染的其他病原体主要为甲型流感病毒、呼吸道合胞病毒、EB病毒、人副流感病毒3型、腺病毒。SP感染患儿临床症状：咳嗽414例、扁桃体肿大302例、发热290例、鼻塞175例、胃肠道反应93例、流涕63例、喘促67例、呼吸困难7例；影像学检查结果：289例提示异常，其中双肺127例、右肺87例、左肺69例，主要表现为斑片及条索影改变243例、肺纹理增粗70例；与非SP感染肺炎患儿相比，白细胞计数、中性粒细胞百分比、中性粒细胞计数、超敏C反应蛋白、血清淀粉样蛋白A、血沉均高（P均<0.05），红细胞、前...     

小儿高热惊厥156例临床分析

小儿高热惊厥为临床常见病。近 5年来 ,我院收治小儿高热惊厥 15 6例。现报告如下。临床资料 :本组 15 6例 ,男 85例 ,女 71例 ;年龄 6个月至 3岁。10 0例体温在 39℃以上 ,12 2例 (占 78.2 % )惊厥出现在发热 2 4小时以内。15 6例中 ,惊厥开始后 10分钟停止者 14 4例 ,至30分钟停止者 12例。15 2例 (占 97% )为全身抽搐 ,4例为局限性抽搐。惊厥初发时 118例 ( 75 .6 % )有上感史 ,2 6例为支气管炎或肺炎 ,其次为腹泻、菌痢、幼儿急疹等疾病。脑电图检查4 4例 ,异常 2 4例。治疗及结果 :入院后主要采用抗感染 ,降温等治疗 ,对有反复惊厥或曾…     

Validity of clinical case definitions for influenza surveillance among hospitalized patients: results from a rural community in North India

Objective: Clinical case definitions used for influenza surveillance among hospitalized patients vary and need systematic evaluation. Design, setting and sample: During July 2009–August 2011, we collected clinical data and specimens (nasal and throat swabs) from rural patients hospitalized for acute medical illnesses. Specimens were tested by rRT‐PCR for influenza viruses. Main outcome measures: Case definitions evaluated the following: influenza‐like illness (ILI: measured fever plus cough or sore throat); severe acute respiratory illness (SARI: ILI with difficulty breathing in ≥5 years, Integrated Management of Childhood Illness–defined pneumonia or severe pneumonia, or physician diagnosed lower respiratory infection in <5 years); acute respiratory infection (ARI: ≥1 of cough, nasal discharge, difficulty breathing or sore throat); febrile acute respiratory illness (FARI: fever plus either cough, sore throat, runny nose, difficulty breathing, or earache). Variants that included “reported fever” and additional sign–symptom combinations were also evaluated. Results: We enrolled 1043 hospitalized patients, including 257 children <5 years of age (range 1 day–86 years). Seventy‐four patients tested influenza virus positive (including 28 A(H1N1)pdm09). Sensitivity(95% CI) and specificity (95% CI) for influenza infection were 78% (67–87) and 60% (57–63) for ILI (measured/reported fever); 37% (26–49) and 78% (75–80) for SARI (measured/reported fever); 82% (72–90) and 57% (54–60) for FARI (measured/reported fever); 88% (78–94) and 45% (42–49) for ARI; and 74% (63–84) and 61% (58–64) for measured/reported fever plus cough. Case definitions including only measured fever had lower sensitivity. Conclusion: ILI and FARI with measured/reported fever provided good balance between sensitivity and specificity among hospitalized patients. The simpler case definition of measured/reported fever plus cough is suited for field surveillance.     

Systematic review of clinical and epidemiological features of the pandemic influenza A (H1N1) 2009

The aim of this systematic review was to summarise the clinical and epidemiological features of the pandemic influenza A (H1N1) 2009. We did a systematic search of published literature reporting clinical features of laboratory-confirmed pandemic influenza A (H1N1) 2009 from 1 April 2009 to 31 January 2010. Forty-four articles met our inclusion criteria for the review. The calculated weighted mean age of confirmed cases was 18·1 years, with the median ranging from 12 to 44 years. Cough (84·9%), fever (84·7%), headache (66·5%), runny nose (60·1%) and muscle pain (58·1%) were the most common symptoms of confirmed cases. One or more pre-existing chronic medical conditions were found in 18·4% of cases. Almost two-thirds (64%) of cases were aged between 10 and 29 years, 5·1% were aged over 50 years and only 1·1% were aged over 60 years. The confirmed case fatality ratio was 2·9% (95% CI 0·0-6·7%), an extracted average from 12 of 42 studies reporting fatal cases (937 fatal cases among 31,980 confirmed cases), which gives an overall estimated infected case fatality ratio of 0·02%. Early in the pandemic, disease occurred overwhelmingly in children and younger adults, with cough and fever as the most prevalent clinical symptoms of the confirmed cases. A high infection rate in children and young adults, with sparing of the elderly population, has implications for pandemic influenza management and control policies.     

云南省82例住院儿童HIV/AIDS临床特征分析

目的分析云南省住院儿童HIV/AIDS临床特点。方法回顾性分析云南省艾滋病关爱中心2006年1月—2015年12月收治的HIV/AIDS患儿人口学资料、流行病学资料、临床表现及合并症、实验室检查、临床转归等。结果 82例HIV/AIDS患儿中,男47例,女35例。其中93.90%(77/82)通过母婴传播感染HIV。年龄为6~15岁占75.60%(62/82),1~6岁占20.73%(17/82),1岁以下占3.66%(3/82)。体格生长评价显示,39例(47.56%)患儿的身高或体质量处于下等,所有患儿身高不达标更为常见。免疫功能重度抑制者44例(53.66%),中度抑制者16例(19.51%)。该组患儿常见的临床表现为慢性或反复咳嗽51例(62.19%),持续或反复发热47例(57.32%),贫血43例(52.44%),营养不良40例(48.78%)等。主要机会性感染诊断:细菌性肺炎25例(30.49%),结核24例(29.27%),鹅口疮16例(19.51%),其中38%的患儿合并有2种及2种以上机会性感染。治疗后好转77例,未愈死亡5例。结论云南省住院儿童HIV/AIDS感染途径以母婴传播为主,患儿生长发育明显受限,免疫功能严重损害,临床表现复杂多样,疾病进展及合并感染疾病谱与HIV/AIDS成人患者有异,儿童HIV/AIDS早诊断、早治疗十分重要。     

Clinical features of influenza C virus infection in children

BACKGROUND: Seroepidemiological studies have revealed that influenza C virus is widely distributed globally. However, because the isolation of this virus is difficult, there have been few reports on its clinical features. METHODS: Between December 1990 and November 2004, 84,946 respiratory-tract specimens were obtained from patients < or = 15 years old. On the basis of the results of isolation of virus, we examined the clinical data on children infected with influenza C virus. RESULTS: Of 170 children infected with influenza C virus, 157 (92.4%) were < 6 years old. Fever (frequency, 90.0%), cough (frequency, 74.1%), and rhinorrhea (frequency, 61.8%) were the most frequent symptoms. The mean duration of fever was 2.88 days (standard deviation, 1.66 days). Of the 170 children, 29 were hospitalized, and 21 (72.4%) of these 29 had lower-respiratory-tract illness such as pneumonia, bronchitis, and bronchiolitis. The rate of hospital admission was significantly higher in children < 2 years old than in children 2-5 years old (30.4% vs. 11.9%; P = .0043). CONCLUSIONS: Influenza C virus is a significant cause of upper-respiratory-tract illness in children < 6 years old, and the risk of complications with lower-respiratory-tract illness is particularly high in children < 2 years old.     

Hospitalization and Complications in Children under 2 Years of Age with Bordetella pertussis Infection

Summary We prospectively followed 725 children under 2 years of age with laboratory-diagnosed Bordetella pertussis infection to investigate the hospitalization rate and complications. Diagnosis was made by culture and polymerase chain reaction (PCR) from nasopharyngeal swabs in 11,016 children who presented with ≥ 7 days of cough at 63 pediatric practices in Germany. Of these children, 33 (4.5%) were hospitalized at a mean age of 4.8 months (range, 17 days to 19.5 months). Complications occurred in 16 (48%) of the 33 patients. Pneumonia developed in two (6%) children and a convulsion was observed in one (3%). Intensive care monitoring was required for 23 (70%) children. Further complications were bradycardia (21%), apnea (12%), conjunctivitis (12%), loss of weight (12%), otitis media (6%), atelectasis (3%) and dehydration (3%). Children aged 6–24 months who had not received any dose of pertussis vaccine had a ten-fold increased risk of hospitalization compared to those who had been partially or fully immunized (p < 0.05). Pertussis immunization should be given at an early point in time and completely in order to prevent severe courses of pertussis and hospitalization in young children. Received: May 4, 1999 · Revision accepted: January 20, 2000     

儿童重症恶性疟258例临床分析

为了解儿童恶性疟临床特征和降低病死率 ,对 1 996～ 1 997年圣多美国家中心医院住院 2 58例儿童恶性疟和有并发症的患儿进行分析。结果表明 ,患儿以 1～ 5岁发生率最高 (占 61 % ) ,痊愈 2 38例 ,留有后遣症者 4例 ,死亡 1 6例 ,病死率为 6.2 %。常见临床特征有发热、贫血、咳嗽及吐泻 ,各重症类型的表现分别有惊厥、意识障碍 ,重度贫血 ,循环衰竭、黄疸、显著浮肿、心律失常及广泛出血等。诊断依据是以血涂片查见疟原虫为准 ,阴性则反复多次检查。尽早抗疟治疗 ,对抗药性及并发症的恰当处理是降低病死率的关键