摘要
目的:探讨小儿传染性单核细胞增多症(Infectious mononucleosis,IM)的临床特征以及误诊原因。方法:对确诊的46例IM患儿的临床资料进行分析。结果:典型临床表现的有31例(67.4%),发热46例(100%),合并腹股沟或腋下淋巴结肿大28例(60.9%),咽峡炎34例(73.9%);异型淋巴细胞大于10%者39例(84.8%),血清嗜异性凝集试验、EB病毒衣壳抗原IgM抗体(EBV-VCA-IgM)阳性率分别为42.9%、39.3%;误诊17例(37.2%),被误诊的疾病有化脓性扁桃体炎、淋巴结炎、白血病、淋巴瘤、急性肾炎、传染性病毒性肝炎、病毒性心肌炎、原发性血小板减少性紫癜和呼吸道感染。结论:小儿IM临床症状多种多样,大部分具有典型症状,部分缺乏特异性,症状不典型时容易造成误诊,对可疑IM者应提高认识,综合判断,尽早诊断及治疗。
Objective： To investigate the clinical and laboratory characteristics and causes of misdiagnosed infectious mononucleosis in children. Methods. The clinical materials of 46 patients who were confirmed with infectious mononucleosis were analyzed. Results ： Thirty-one cases （67.4 %） had the typical clinic characteristics of infectious mononucleosis,46 cases（100 %） had fever,28 cases（60.9 %） had enlargement of lymph nodes in groin or armpit, 34 cases （73.9 %） had angina; 39 cases（84.8 %）were more than 10 % special lymph cells. The positive rates of hertrophil agglutination test and EBV-VCA-IgM were 42.9% and 39.3% respectively. Seventeen patients were misdiagnosed,the wrong diagnose rate was 37%. The diseases,which were wrong diagnosed, were purulent tonsillitis, lymph nudities, leukemia, lymph tumor, acute glomeruonephritis, infectious viral hepatitis,viral myocarditis, idiophthic thrombocytopenic and respiratory tract infection. Conclusion： The signs or symptoms of infectious mononucleosis were many and varied and most have the typical signs,but part is lack of characteristics, wrong diagnosis may occur easily when the signs or symptoms are not typical. So, suspicious infection patients should be advanced cognition, diagnosed and treated as early as possible.
出处
《实用临床医学（江西）》
CAS
2007年第1期86-87,93,共3页
Practical Clinical Medicine
关键词
传染性单核细胞增多症
临床特征
误诊
infectious mononucleosis
clinical characteristics
wrong diagnosis
