新生儿登革热4例报告

Neonatal dengue fever: four cases report

目的探讨新生儿登革热的临床特点。方法回顾性分析2014年收治的4例新生儿登革热患儿的临床资料,并进行相关文献复习。结果 4例登革热患儿均为男性;3例为母婴垂直感染,生后第1～7天发病,母亲产前发热,围生期确诊登革热;1例为社区获得性,生后第21天发病,前一天受蚊虫叮咬。4例患儿均有发热,皮疹2例、出血点1例,均无黄疸和咳嗽。4例患儿均有血小板减少（30～125）×10^9/L、部分活化凝血酶原时间延长（44.0～89.8 s）、天冬氨酸转氨酶（AST）升高（46～71 U/L）,3例纤维蛋白原下降（1.36～2.53 g/L）,2例肌酸激酶同工酶（CK-MB）升高（29～86 U/L）,2例C-反应蛋白（CRP）增高（3.00～46.05 mg/L）。4例患儿经抗感染、静脉注射丙种球蛋白治疗,均治愈出院;住院时间4～17 d。结论新生儿登革热临床表现以发热、凝血功能障碍为主。临床症状较轻,且缺乏特异性,预后良好。母婴垂直传播是感染登革病毒传染途径之一。

Objective To explore the clinical characteristics of neonatal dengue fever. Methods The clinical data from 4 neonates with dengue fever who were admitted and treated in 2014 were retrospectively analyzed and the related literatures had been reviewed. Results Four cases of neonatal dengue fever were all males. Three cases were mother to child transmission, the age at onset was 1 to 7 days after birth, and their mothers suffered with prenatal fever and were diagnozed of dengue fever during perinatal period. One case was community acquired, the age at onset was day 21 after birth and the neonate was bit by mosquito the day before. All four neonates had fever, two cases had rash, and one case had hemorrhagic spot. None of them had jaundice or cough. All of them had thrombocytopenia（ 30- 125）× 10^9/L, prolonged activated partial thromboplastin time（ 44. 0- 89. 8 s）, and increased aspartate aminotransferase（AST）（46-71 U/L）. Three cases had declined fibrinogen（1.36-2.53 g/L）. Two cases had increased CK-MB（ 29- 86 U/L）. Two cases had increased CRP（ 3. 00- 46. 05 mg/L）. After the treatment of anti-infection and intravenous immunoglobulin, all of them were cured and discharged. The duration of hospital stay was 4- 17 days. Conclusion The clinical manifestations of neonatal dengue fever were mainly fever and blood coagulation dysfunction, clinical symptoms are mild and lack of specificity, and prognosis are good. Mother to child transmission is one of the ways of dengue virus infection.