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病例24-2017:一名发热并有腹部肿块的8月龄女婴
Case 24-2017 — An 8-Month-Old Girl with Fever and an Abdominal Mass


Uzma Shah ... 肿瘤 妇产科和儿科 • 2017.08.10

病例陈述


Rajitha Venkatesh医师(儿科):一名8月龄女婴因发热和腹部肿块被收入本院。

该患儿入院前6日排出外部有凝血的大量粪便,之前她的健康状况正常。此后4日内,她出现间歇发热伴相关的易激惹、进食减少但无呕吐。她持续每日尿湿6~8块尿布,排出棕色软便。入院前一日出现轻度咳嗽。患者的儿科医师在其诊所对其进行了评估并预约第二日进行腹部超声检查。当晚患者体温升至40.3℃;她的父母给她服用了布洛芬并将她送至另一家医院的急诊科。

在该医院检查时,患者表现出轻度不适。体温39.4℃,血压102/58 mmHg,脉搏170次/分,呼吸频率32次/分,呼吸周围环境空气时的氧饱和度99%。体重是9.53 kg(第93百分位数)。囟门开放、柔软而平坦。腹部中度膨隆,肠鸣音正常,触诊无明显压痛;其余检查均正常。给服对乙酰氨基酚,体温降至36.1℃。分析导尿获得的尿样显示,pH 5.0,比重1.005,少量尿血,尿胆素原水平0.2 mg/dL,其余结果均正常。未能获得血液样本。





作者信息

Uzma Shah, M.D., Allan M. Goldstein, M.D., Michael S. Gee, M.D., Ph.D., and Vikram Deshpande, M.D.
From the Departments of Pediatrics (U.S.), Pediatric Surgery (A.M.G.), Radiology (M.S.G.), and Pathology (V.D.), Massachusetts General Hospital, and the Departments of Pediatrics (U.S.), Surgery (A.M.G.), Radiology (M.S.G.), and Pathology (V.D.), Harvard Medical School — both in Boston.

 

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