查詢結果分析
相關文獻
- Fever in Infants Less Than 3 Months of Age
- Circulating Chemokine Levels in Febrile Infants with Serious Bacterial Infections
- 新生兒及幼小嬰兒發燒的診斷與治療
- A Model for Predicting Risk of Serious Bacterial Infection in Febrile Infants Younger Than 3 Months of Age
- 關於嬰兒的發燒
- 臺灣感染COVID-19的新生兒和三個月以下嬰兒的流行病學和嚴重程度:單中心回顧性研究
- Magnetic Resonance Cholangiography for Evaluation of Cholestatic Jaundice in Neonates and Infants
- 新生兒嬰兒之腦神經發展與其異常發現
- 認識小兒發燒
- 冰枕與冰毯機對加護病房中顱內損傷發燒病患之降溫效果、舒適情況與影響因素之探討
頁籤選單縮合
| 題 名 | Fever in Infants Less Than 3 Months of Age=小於三個月大嬰兒的發燒 |
|---|---|
| 作 者 | 邱政洵; 林奏延; | 書刊名 | 中華民國小兒科醫學會雜誌 |
| 卷 期 | 35:4 民83.07-08 |
| 頁 次 | 頁273-279 |
| 分類號 | 417.5103 |
| 關鍵詞 | 發燒; 嬰兒; 嚴重細菌感染; Fever; Young infant; Serious bacterial infection; |
| 語 文 | 英文(English) |
| 中文摘要 | 嬰兒發燒是小兒科醫師常常碰到也是最具挑戰性的問題,有些嚴重的細菌感染,其臨床表征除了發燒外常常不甚明顯。我們針對在一年之內,小於三個月大嬰兒,因爲發燒(肛溫≧38℃)而到本院小兒科急診室就診的207個例做一回溯性研究。我們發現大部份病兒的肛溫介於38到39.9℃,只有6(3%)人次的肛溫超過40℃。207人次中有109(53%)人次的病兒住院,其中尤以一個月內大的新生兒比二個月或三個月內大的嬰兒住院的比例較高。在診斷方面,尿道炎及上呼吸道感染分別是最常見的細菌及病毒感染。如果在病兒的血液、腦脊髓液、尿液、糞便、骨頭、關節液或膿液中分離出致病菌,則稱爲嚴重細菌感染。Dagan等人曾是提出一套用來排除嚴重細菌感染的低色險因子,如果一位小於三個月大發燒嬰兒符合這套低危險因子,則被歸於低危險群,幾乎可以排除嚴重細菌感染的可能,他們的數據顯示陰性預期值逹99.3%著者等以112位小於三個月大發燒嬰兒的資料來檢測這套低危險因子,結果符合這套低危險因子而歸於低危險群的76位嬰兒中有7(9.2%)位是屬於嚴重細菌感染;36位嬰兒有一項或一項以上不符合低危險因子而被歸於高危險群,其中有16(44.4%)位屬於嚴重細菌感染,二者雖有統計學上的差異,但是陰性預期值只有90.8%。雖然歸於低危險群但卻是嚴重細菌感染的嬰兒的診斷有菌血症、尿道炎及沙門氏菌腸炎。因此爲了增加這套低危險因子的陰性預期值,我們建議可以攷慮加上另一低危險因子,即常規糞便檢查沒有潛血及膿細胞存在;至於非膿尿性尿道炎,根據文獻記載,在嬰兒並不少見,亦需特別注意。本研究顯示,這套用來排除小於三個月大嬰兒的發燒是肇因於嚴重細胞感染的低危險因子,有其在臨床上應用的缺點,在廣泛應用之前,還需做較大規模且前瞻性的評估。 |
| 英文摘要 | A retrospective study of 207 febrile episodes by infants less than 3 months old was performed. Most infants had rectal temperatures ranging from 38 to 39.9℃ and only 6 (3%) infants had fever above 40℃ per rectum. One hundred and nine (53%) of 207 visits resulted in subsequent hospitalizations including most by infants under 1 month of age. Urinary tract infection was the most common bacterial infection and upper respiratory tract infection the most common viral infection observed. A total of 112 infants were assigned into high-risk or low-risk group for serious bacterial infection by the application of the criteria proposed by Dagan et al. in 1985. The overall incidence of serious bacterial infection was 20.5% (23 patients). Seven (9.2%) of the 76 infants in the low-risk group had serious bacterial infection, compared with 16 (44.4%) of the 36 in the high-risk group (p<0.05). The negative predictive value of meeting the criteria was 90.8%, a value unacceptably lower than those of previous studies. For maximizing the negative predictive power of the criteria, the addition of another low- risk factor, a normal stool analysis, is suggested. Besides, urine cultures should be taken concomitantly with urinalyses in febrile infants, when considering nonpyuria in infants with urinary tract infections. We demonstrate the pitfalls and difficulties in the application of the criteria for excluding serious bacterial infection in febrile young infants and suggest prospective studies involving more patients should be undertaken before its wider application in clinical practice. |
本系統中英文摘要資訊取自各篇刊載內容。