儿童传染性单核细胞增多症误诊为麻疹样红斑型药疹1例

Infectious Mononucleosis Misdiagnosed as Erythema Morbilliforme Drug Eruptions in A Child

患儿男，3岁10个月。发热4d，全身皮疹2d。呈中高热，皮肤无瘙瘁。外院以麻疹样红斑型药疹治疗效果欠佳。查体：T39．2℃，急性病面容，颈部触及多个淋巴结，扁桃体Ⅱ～Ⅲ°，肝脏肋下3cm，脾脏肋下2cm。皮肤科情况：全身泛发的大小不一红斑。血WBC18．8×10^9／L，变异淋巴细胞百分比16％。血液EBV-PCR3．6×10^5copy／mL。诊断：传染性单核细胞增多症。

A boy of three years and ten months old presented with moderate - severe fever for 4 d, companied with generalized erythema for 2 d. He was diagnosed as drug eruptions and treated with methylprednisolone, but no improvement in fever and skin rash. Physical examinations found high fever, stress facies, deradenoncus, and hepatosplenomegaly. Generalized pinkish erythema were obvious. Blood routine test suggested significant elevation of WBC and notable increase of abnormal lymphocytes. EBV - IgG and IgM antibody in peripheral blood was examined. High replication of EBV genes was obtained. The diagnosis of infectious mononucleosis was established.