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頁籤選單縮合
題名 | Disseminated Pneumococcal Infection with Pericarditis and Cardiac Tamponade: Report of One Case=散發性肺炎鏈球菌感染併發心包膜炎及心包膜填塞:一病例報告 |
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作者 | 符凌輝; 陳俊達; 周琪; | 書刊名 | 臺灣兒科醫學會雜誌 |
卷期 | 46:5 民94.09-10 |
頁次 | 頁301-304+334 |
分類號 | 417.5351 |
關鍵詞 | 肺炎鏈球菌; 心包膜炎; 心包膜填塞; Pneumococcus; Pericarditis; Cardiac tamponade; |
語文 | 英文(English) |
中文摘要 | 一歲五個月大女童主訴咳嗽,流鼻涕,持續發燒19天,因呼吸困難,低血壓與發紺住到加護病房並立即被插管。理學檢查顯示右肺呼吸音及心音減小,超音波檢查顯示心包膜填塞,X光檢查顯示心臟肥大及右側水胸、氣胸。病人進行了心包膜穿刺術、胸管引流術,並以抗生素治療。所有送檢的檢體都證實為肺炎鏈球菌感染。進一步的骨髓炎掃瞄顯示右邊腸骨骨髓炎,於是進行了外科清創術。病患於54天後完全康復並出院。之後持續追蹤了18個月,並沒有併發限制性心臟病。 |
英文摘要 | A 1 year 5 months old female who had cough, rhinorrhea and prolonged fever for 19 days was admitted to the intensive care unit due to exertional dyspnea. She was intubated promptly in virtue of hypotension and cyanosis. The physical examination demonstrated diminished breathing sound over the right lung and distant heart sound; echocardiogram showed cardiac tamponade. Further X ray study showed right hydropneumothorax and cardiomegaly. Pericardiocentesis and chest thoracostomy were performed, and subsequently all the cultures showed growth of Streptococcus pneumoniae. Antibiotics therapy was started promptly after admission. Further investigation indicated osteomyelitis of the right ilium, so that surgical debridement was done. The patient was discharged 54 days later with complete recovery. After following up for 18 months, no restrictive heart disease developed. Purulent pericarditis with cardiac tamponade is an extremely rare complication of pneumococcal infection. |
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