X-连锁高IgM综合征1例报告

<正>病例资料患儿男,3岁1个月,因反复发热4个月,再发6 d于2014年9月7日入院。患儿4个月前因接种"流感疫苗"后出现发热,体温在38.0℃左后,无咳嗽或腹泻,于当地诊所静脉滴注头孢类抗生素(具体不详)7 d后体温降至正常,但停药3 d后再次发热,再次于当地社区医院输注头孢类抗生素(具体不详)5 d体温正常,以后每隔3-5 d反复发热,体温波动在38℃~39℃左右,每次持续10至20 d,     

肺炎支原体肺炎并发斯-琼综合征1例

1病例报告患儿女,1岁8个月。因发热、咳嗽4d于2010-08-23入天津市第三中心医院。入院前4d患儿出现咳嗽,有痰、不易咳出。伴发热,体温最高40℃,无寒战、抽搐及皮疹等。发热时家长自行予退热药(具体不详)对症处理,     

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1病历资料患儿女,2岁6个月。因"发热、咳嗽10d"于2010-07-31入安徽省合肥市安徽省立儿童医院。患儿入院前10d无明显诱因出现发热、咳嗽,体温最高达39.8℃。热前无畏寒,发热不伴寒颤,咳嗽不剧烈,无咳痰。当地卫生院给予输注头孢菌素类(具体药物及剂量不详)治疗4d,体温仍在39.0℃左右,转至当地县医院行X线胸片检查示右肺中叶实变,先后予以输注青霉素、阿奇霉素、头孢吡肟、炎琥宁5d,每天仍发热,体温持续在39.0℃左右,转入我院。     

外周血象一过性缓解的儿童急性非淋巴细胞白血病1例报告

患儿，男，3岁，满族。因发热，伴面苍、乏力3周于2002．12．27入院。患儿于入院3周前无明显诱因出现发热，当时最高体温38．5℃，伴面苍、乏力，咳嗽、咳少量白痰。当地医院诊为“感冒”，予抗炎及对症治疗，两天后体温降至正常。一周后体温复升，对症治疗无效，查血常规为全血细胞少(具体不详)，     

间断发热视物模糊抽搐

第一次查房主治医师查房,入院两天。住院医师汇报病史。患儿,男,10岁,间断发热12d,咳嗽1 d入院。入院前12 d,无明显病因出现发热,伴畏寒、寒战、恶心,无呕吐、皮疹,体温最高39·0℃,伴一过性头痛,服用退热药体温可下降,于外院查便常规未见异常,静点头孢类药物(具体药物不详)4 d,体温有所好转,于入院前数天体温降至正常。入院前2 d患儿再次出现发热,最高达40·2℃,服用退热药可降至正常,但很快回升,于入院前1 d出现间断性咳嗽,就诊于我院门诊,查血常规示WBC 7·9×109/L,N 0·711,尿常规WBC 0~2个/HP,RBC3~5个/HP,给予静点芙琦星、博效…     

反复发热、咳嗽、肝肿大伴杵状指——临床病例(理)讨论第64例

1　病历摘要患儿男 ,8岁。因间断发热、咳嗽、咯痰 3年 ,加重伴发热、气促 15天 ,于1999年 1月 2 1日入院。患儿于 3年前无诱因出现咳嗽、咯痰 ,为白色泡沫样痰 ,无脓痰及咯血 ,伴发热 ,于当地医院治疗 (具体诊治不详 ) 1～ 2天体温即降至正常 ,咳嗽、咯痰 3～ 5天消失。但反复发作 ,每次发作症状类似 ,每隔 10天至 2个月发作 1次 ,近半年发作次数增多 ,每隔 5～ 10天发作 1次。入院 15天前又出现上述症状 ,渐加重伴气促 ,体温 38～ 40℃ ,于午后开始发热 ,夜间降至正常 ,在当地医院拟诊肺部感染、肺不张 ,予先锋必、氧哌嗪青霉素治疗7天无…     

他巴唑致抗中性粒细胞胞浆抗体相关性血管炎一例

患儿,女,7岁,因“肉眼血尿1周,发热3d”入院。患儿入院前1周无明显诱因出现肉眼血尿,无尿急、尿频、尿痛,家人未在意。入院前3d出现发热,体温最高38．5℃,伴有单声咳嗽,于院外肌注药物2次（具体不详）,效果差,     

间断咳嗽、憋气二个月一例

病例摘要 患儿女,3个月,因"间断咳嗽、憋气2个月"收治.2个多月前无诱因患儿出现憋气、咳嗽,于当地诊断为"肺炎",住院治疗,静点"头孢类"抗生素5天,症状好转出院.其后患儿反复出现憋气、咳嗽,当地医院均按"肺炎治疗".入院前3天,上述表现加重,并出现口周绀,恶心,伴发热半天,体温最高38.7℃,无呛、吐奶及咯血.病程中,患儿精神可,纳少,二便正常.     

第122例--发热、喘息、左上肺实变影

患儿男,7个月。因咳嗽、喘息伴发热3d入院。患儿于入院前3d受凉后出现咳嗽,阵发性,较剧烈,痰不多,偶呈犬吠样;有喘息、声嘶,呼吸费力;伴有发热,体温波动于38．0～39．8℃（肛温）,无寒战、惊厥。在我院门诊予“头孢呋辛”、“地塞米松”等治疗,体温略有下降,但咳嗽、喘息、声嘶仍存。患儿系试管婴儿,G1P1,双胎之大;     

4个月婴儿患麻疹1例

2患儿，女，4个月，因“发热4天，耳后、发际、面颈部斑丘疹5h”于2004年12月3日10am就诊，患儿于发病前1周曾接触过麻疹患儿。就诊前4天开始出现发热，无一定热型，体温波动在38℃～40℃之间。伴喷嚏、流涕、干咳，咳嗽渐加重，呈刺激性咳嗽。眼结膜充血，流泪羞明，精神萎靡、食欲减退。在乡村医务室以“上呼吸道感染”治疗无好转。病程持续3天后，患儿耳后、发际出现玫瑰红色斑丘疹，渐波及额部、面颈部而到我科就诊。     

Prognosis of convulsions between 1 and 6 months of age

The prognosis of 28 infants presenting consecutively to a general paediatric unit with convulsions between 1 and 6 months of age was far better than had been reported previously. Between 1 and 4 years after presentation the condition of 19 patients was normal, 3 were mildly handicapped, 4 severely handicapped, and 2 had died. Normal physical examination and electroencephalogram at time of presentation, and easy control of convulsions were associated with a satisfactory outcome.     

Prostaglandin E1 responsive ductus at 11 months of age

Summary An 11-month-old boy with congestive heart failure and an intermittently closing patent ductus arteriosus (PDA) is presented. During cardiac catheterization, the ductus proved responsive to prostaglandin E₁. Permanent closure of the PDA could not be attained with indomethacin. The infant underwent surgical ligation of the PDA.     

Prognosis of convulsions between 1 and 6 months of age.

The prognosis of 28 infants presenting consecutively to a general paediatric unit with convulsions between 1 and 6 months of age was far better than had been reported previously. Between 1 and 4 years after presentation the condition of 19 patients was normal, 3 were mildly handicapped, 4 severely handicapped, and 2 had died. Normal physical examination and electroencephalogram at time of presentation, and easy control of convulsions were associated with a satisfactory outcome.     

Reference data for head circumference and 1-month increments from 1 to 12 months of age

Serial head circumference measurements in 462 participants in the Fels Longitudinal Study were used to develop reference data for ages 1 to 12 months. We used a three-parameter mathematical function to model the serial head circumference data for each individual and estimated head circumference at 1-month intervals. Reference data for selected percentiles of head circumference status and 1-month increments were calculated from the estimated head circumferences. These reference data are presented in tables and charts for use in testing hypotheses about group differences or to monitor changes within individuals.     

Night-time non-nutritive sucking in infants aged 1 to 5 months: relationship with infant state, breastfeeding, and bed-sharing versus room-sharing

AIM: Epidemiological studies suggest that pacifier use may be protective against SIDS but little is known of the relationship between pacifier use and other forms of non-nutritive sucking (NNS) in infancy, or of patterns of NNS during the night, when most SIDS deaths occur. We report the first longitudinal study of NNS by direct overnight observations in healthy infants in a sleep laboratory. METHODS: Healthy, breast fed term infants (n = 10) were enrolled at birth, and sequential overnight polygraphic and infrared video recordings of infants with their mothers performed at monthly intervals from 1 to 5 months. Each month, mother baby pairs were randomized to 1 night bed-sharing (BN) then 1 room-sharing (RN), or vice versa. 'Episodes' of pacifier, own digit and mother's digit sucking (> 1 min) were identified and compared with state-matched control periods without sucking or feeding before and after each such episode. RESULTS: 329 episodes of NNS were identified in 749 h of video recording. The prevalence of pacifier sucking decreased with age, whilst digit sucking increased. Routine pacifier users rarely sucked their digits. There were temporal differences throughout the night in the distribution of different types of sucking and in infant state during and around sucking episodes. Sleeping in the 'non-routine' location was associated with a larger percentage of nights with sucking episodes and increased sleep latency. Bed sharing (routinely or on a given night) was associated with less sucking behavior and more breastfeeding. Non-nutritive sucking was not, however, associated with decreased total time breastfeeding per night or number of feeds per night. CONCLUSION: Patterns of NNS during the night change with age and are affected by maternal proximity. Digit sucking has state modulating effects, and may be suppressed by pacifier use. Thus any benefits of pacifier use must be set against the potential loss of a self-directed ability to modulate state during the night, and possible shortening of breastfeeding duration.     

Cytokines (IL-1beta, IL-6, TNF-alpha, TGF-beta1, and TGF-beta2) and prostaglandin E2 in human milk during the first three months postpartum.

Postpartum changes in the concentrations of IL-1beta, IL-6, tumor necrosis factor-alpha (TNF-alpha), transforming growth factor-beta1 (TGF-beta1), TGF-beta2, and prostaglandin E2 in 257 human milk samples collected longitudinally from 49 healthy mothers during the first 12 wk of lactation were determined by ELISA or RIA. The proinflammatory cytokines IL-1beta, IL-6, and TNF-alpha were present in only a proportion of samples, and there was a wide range of concentrations detected at each time in the present study (IL-1beta, <15-400 pg/mL; IL-6, <15-1032 pg/mL; TNF-alpha, <15-2933 pg/mL). Concentrations of prostaglandin E2 increased after the first week and remained elevated for the remainder of the study (range, < 10-9966 pg/mL). The antiinflammatory cytokines TGF-beta1 (range, 43-7108 pg/mL) and TGF-beta2 (range, 208-57935 pg/mL) were present in substantial quantities in all samples, and there was little change in the mean concentration during 12 wk of lactation. The present study shows that immunomodulating agents are normally present in human milk in physiologically relevant quantities for at least the first 3 mo of the breast-fed infant's life.