NEJM:婴儿百日咳-病例报道

2019-07-11 xing.T MedSci原创

在年幼婴儿中,百日咳的并发症包括呼吸暂停、心动过缓、肺炎、癫痫发作和死亡。患者及其父母和祖母接受阿奇霉素治疗。在住院期间,患者反复发作咳嗽、呼吸暂停、氧饱和度下降至50%以下、心动过缓(心率每分钟50次),这导致使用袋式面罩通气作为救援措施。她还接受了补充氧气和鼻饲喂养。

患者为一名8周大的女孩,因咳嗽恶化2周而就诊,她没有发热。她的父母听到了与咳嗽有关的百日咳,并在她的呼吸过程中目睹了停顿。她曾接触过最近患有咳嗽的祖母,她祖母的咳嗽被认为是支气管炎。其祖母的疫苗接种史不详。婴儿的母亲在怀孕期间接种了破伤风-白喉-无细胞百日咳(Tdap)疫苗;鉴于她的年龄,婴儿尚未接种疫苗。

体格检查发现与咳嗽相关的特征性百日咳。实验室检查发现白细胞计数为每立方毫米14500(参考范围为6900至12800),伴有淋巴细胞增多症。用鼻咽抽吸物样品进行的聚合酶链反应证实了百日咳博德特氏菌感染



在年幼婴儿中,百日咳的并发症包括呼吸暂停、心动过缓、肺炎、癫痫发作和死亡。患者及其父母和祖母接受阿奇霉素治疗。在住院期间,患者反复发作咳嗽、呼吸暂停、氧饱和度下降至50%以下、心动过缓(心率每分钟50次),这导致使用袋式面罩通气作为救援措施。她还接受了补充氧气和鼻饲喂养。

她总共住院了25天,在出院后3个月的随访中,患者身体状况良好且发育正常,并且她没有咳嗽。
 
原始出处:

Debra Hillier,et al.Whooping Cough in a Young Infant.N Engl J Med 2019;https://www.nejm.org/doi/full/10.1056/NEJMicm1814607

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  2. [GetPortalCommentsPageByObjectIdResponse(id=1391727, encodeId=37fd1391e2745, content=<a href='/topic/show?id=f5a8e1878f0' target=_blank style='color:#2F92EE;'>#百日咳#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=52, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=71878, encryptionId=f5a8e1878f0, topicName=百日咳)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTKCRibWHQArPHdSkqP90U1HwwqlGeU7BUgzY240D3v2ibBDJ09ybkGkwOjxz7qRmngZaGlK1taX6hfA/132, createdBy=2e772500094, createdName=小华子, createdTime=Fri Jul 12 22:40:00 CST 2019, time=2019-07-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1034882, encodeId=74fe1034882ea, content=顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Thu Jul 11 10:40:00 CST 2019, time=2019-07-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=369467, encodeId=7dc936946eff, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=73, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1bb241978, createdName=phoebeyan520, createdTime=Thu Jul 11 10:04:55 CST 2019, time=2019-07-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=369455, encodeId=ea80369455d1, content=学习谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=83, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4Nd44v3xHnnictn9UpctwtH62EPQ59TMdI9lnqHMgQ16nH7GmGCfpzicsHgjibYVk6vwSpXrC86gMibRkoaIzf5HwSz7/0, createdBy=78cc1691107, createdName=龙胆草, createdTime=Thu Jul 11 08:31:33 CST 2019, time=2019-07-11, status=1, ipAttribution=)]
    2019-07-11 旺医

    顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息

    0

  3. [GetPortalCommentsPageByObjectIdResponse(id=1391727, encodeId=37fd1391e2745, content=<a href='/topic/show?id=f5a8e1878f0' target=_blank style='color:#2F92EE;'>#百日咳#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=52, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=71878, encryptionId=f5a8e1878f0, topicName=百日咳)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTKCRibWHQArPHdSkqP90U1HwwqlGeU7BUgzY240D3v2ibBDJ09ybkGkwOjxz7qRmngZaGlK1taX6hfA/132, createdBy=2e772500094, createdName=小华子, createdTime=Fri Jul 12 22:40:00 CST 2019, time=2019-07-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1034882, encodeId=74fe1034882ea, content=顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Thu Jul 11 10:40:00 CST 2019, time=2019-07-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=369467, encodeId=7dc936946eff, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=73, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1bb241978, createdName=phoebeyan520, createdTime=Thu Jul 11 10:04:55 CST 2019, time=2019-07-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=369455, encodeId=ea80369455d1, content=学习谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=83, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4Nd44v3xHnnictn9UpctwtH62EPQ59TMdI9lnqHMgQ16nH7GmGCfpzicsHgjibYVk6vwSpXrC86gMibRkoaIzf5HwSz7/0, createdBy=78cc1691107, createdName=龙胆草, createdTime=Thu Jul 11 08:31:33 CST 2019, time=2019-07-11, status=1, ipAttribution=)]
    2019-07-11 phoebeyan520

    学习了

    0

  4. [GetPortalCommentsPageByObjectIdResponse(id=1391727, encodeId=37fd1391e2745, content=<a href='/topic/show?id=f5a8e1878f0' target=_blank style='color:#2F92EE;'>#百日咳#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=52, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=71878, encryptionId=f5a8e1878f0, topicName=百日咳)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTKCRibWHQArPHdSkqP90U1HwwqlGeU7BUgzY240D3v2ibBDJ09ybkGkwOjxz7qRmngZaGlK1taX6hfA/132, createdBy=2e772500094, createdName=小华子, createdTime=Fri Jul 12 22:40:00 CST 2019, time=2019-07-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1034882, encodeId=74fe1034882ea, content=顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Thu Jul 11 10:40:00 CST 2019, time=2019-07-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=369467, encodeId=7dc936946eff, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=73, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1bb241978, createdName=phoebeyan520, createdTime=Thu Jul 11 10:04:55 CST 2019, time=2019-07-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=369455, encodeId=ea80369455d1, content=学习谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=83, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4Nd44v3xHnnictn9UpctwtH62EPQ59TMdI9lnqHMgQ16nH7GmGCfpzicsHgjibYVk6vwSpXrC86gMibRkoaIzf5HwSz7/0, createdBy=78cc1691107, createdName=龙胆草, createdTime=Thu Jul 11 08:31:33 CST 2019, time=2019-07-11, status=1, ipAttribution=)]
    2019-07-11 龙胆草

    学习谢谢分享

    0

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