误诊为呼吸道感染的八例儿童传染病临床分析

Clinical Analysis of 8 Children with Infectious Diseases Misdiagnosed as Respiratory Tract Infection

目的分析儿童传染病误诊为呼吸道感染的相关原因,以降低误诊率,提高诊治水平。方法回顾性分析误诊为呼吸道感染的8例儿童传染病的临床资料。结果2例分别因发热、咳嗽伴咽痛3 d、5 d入院;2例分别因口腔疼痛4 d、6 d,发热2 d、3 d入院;1例因发热2 d,加重1 d入院;2例因发热1 d入院;1例因反复发热5 d入院。本组误诊为支气管肺炎、上呼吸道感染合并口腔溃疡各2例,上呼吸道感染4例,误诊时间2~4 d,均予相应处理,但症状未见好转。后进一步完善相关检查,确诊为麻疹、手足口病、幼儿急疹各2例,流行性腮腺炎、传染性单核细胞增多症各1例,予以隔离及对症治疗后痊愈出院。结论多数传染病早期临床症状类似于呼吸道感染,临床应加强对儿童传染病的了解和认知,分析相关传染病的临床特点,拓宽诊断思维,进行全面综合检查,以降低误诊率,提高诊治水平。

Objective To analyze the causes of misdiagnosis of infectious diseases in children as respiratory tract infection(RTI),so as to reduce the misdiagnosis rate and improve the level of diagnosis and treatment.Methods The clinical data of 8 cases of infectious diseases misdiagnosed as RTI by our hospital were analyzed retrospectively.Results Two cases were admitted to our hospital due to fever and cough with sore throat for 3 and 5 days respectively;two cases were admitted due to oral pain for 4 and 6 days and fever for 2 and 3 days respectively;one case was admitted due to fever for 2 days and aggravation for 1 day;two cases were admitted due to fever for 1 day;and one case was admitted due to repeated fever for 5 days.In this group,2 cases were misdiagnosed as bronchopneumonia,2 cases as upper respiratory tract infection(URTI)combined with oral ulcers,and 4 cases as URTI,and the duration of misdiagnosis was 2 to 4 days.All patients were treated accordingly,but their symptoms were not relieved.After further examinations,there were 2 cases diagnosed with measles,2 cases with hand and foot mouth disease,2 cases with acute rash,1 case with mumps and 1 case with infectious mononucleosis.The children were isolated,and discharged after recovery following symptomatic treatment.Conclusion Most of the early clinical symptoms of infectious diseases are similar to those of URTI.Therefore,we should strengthen the understanding and awareness of children's infectious diseases,understand the clinical characteristics of related infectious diseases,broaden our thoughts of diagnosis and conduct comprehensive examination,in order to reduce the misdiagnosis rate and improve the level of diagnosis and treatment.