婴幼儿“无源发热”的研究

Dr. Syed Aafaq Zishan Abid, S. Kumbhar, Kishan G. Takrani, Arshi Ishteyaq
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摘要

背景:发烧是儿科医生和家长在儿科实践中最常见和最麻烦的表现之一。这是一种简单明了的疾病的良好标志。发烧可能是单纯病毒感染的良性表现,也可能是威胁生命的细菌感染的表现,如败血症和化脓性脑膜炎。这是一种常见的、可怕的生理反应,在整个儿科实践史上一直是最大的投诉来源。方法:分析性横断面研究。结果:本研究共纳入60例。年龄在1 ~ 3月龄的患者占3.3% (n=2), 4 ~ 36月龄的患者占31.6% (n=19), 37 ~ 60月龄的患者占65% (n=39)。女性n=31比男性n=29多。在本研究中,11.6% (n=7)的病例最终诊断为UTI。其中败血症占10% (n=6),立克次体热占13.3% (n=8),伤寒占11.6% (n=7),登革热占3.3% (n=2),川崎病占5% (n=3)。其余45% (n=27)的患者病因不明。结论:尿路感染、立克次体感染和肠道热是无源发热的常见原因。“无源发热”造成了诊断困境,需要详细评估以发现感染、全身性疾病或隐匿性菌血症的潜在病因。在我们的研究中,尽管进行了彻底的调查,但大多数患者没有发现病因。
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Study of ‘Fever without source’ in Infants and young children
Background: Fever is one of the most common as well as trouble some manifestation in paediatric practice, both for paediatricians and parents. It is a simply noted an good marker of illness. Fever could be benign presentation of simple viral infection or it can be a presentation of life threating bacterial infection like sepsis and pyogenic meningitis. It is a common, terrifying, physiologic response that has been the source of biggest complaint throughout the history of paediatric practice. Methods: Analytical Cross-sectional Study. Results: In present study, 60 cases were included. Age group between 1-3 months was 3.3% (n=2) of the patients, 4-36 months was 31.6% (n=19) of the patients and 37-60 months was 65% (n=39) of the patients. Female n=31 more than male n=29. Final diagnosis was of UTI in 11.6% (n=7) of the cases taken in the study. Sepsis was diagnosed in 10% (n=6), Rickettsial Fever was diagnosed in 13.3% (n=8), Typhoid fever was diagnosed in 11.6% (n=7), Dengue was diagnosed in 3.3% (n=2) and Kawasaki’s disease was diagnosed in 5% (n=3) of the patients. Rest 45% (n=27) of the patients where cause was unknown. Conclusion: UTI, Rickettsial infection and Enteric fever were among common cause of Fever without source. “Fever without source’ pose a diagnostic dilemma and require detail evaluation to detect underlying etiology of infection, Systemic illness or Occult bacteremia. Majority of the patients no etiology was found in our study, Inspite of thorough investigation.
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