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发帖数: 1904 | 1 【 以下文字转载自 MedicalCareer 讨论区 】
发信人: Blazer (--), 信区: MedicalCareer
标 题: 求助：５岁小孩高烧１０天
发信站: BBS 未名空间站 (Sat Feb 2 23:01:40 2013, 美东)
看了三次医生，没有任何进展。可能下周要收入院了。小地方没有儿童医院，也不知道
该不该换个别的医生。恳请大家帮着瞧瞧 （病人情况如下）。万分感谢。
5 yo female with persistent cough x 14 days and fever x 10 days. Fever runs
102-104 F, but does normalize when given motrin or tylenol. Symptom no
improvement after 4 days of Azithromycin. Began to have loose stool /watery
diarrhea for past 3-4 days. She had complained of abdominal pain (mostly
peri-umbilical) intermittently for the past 2-3 weeks. Has a history of
problems with constipation. Slightly decreased PO intake, but still drinking
okay. Still playful when fever weans off by antipyretic. No headache/rash/
eye pain. No joint pain but sometimes complains lower extremities numbness
when she is sitting on the toilet.
No significant PMHx other than inguinal hernia. No significant FHx.
PE: 1+ tonsil without exudates, shotty cervical LN, vague abdominal pain,
otherwise no significant changes.
LAB:
1. CBC diff: Normal WBC, but left shift (no bands); no anemia
2. Elevated ESR (65) and CRP (48)
3. CMP: normal
4. UA: Trace blood, otherwise normal
5. Rapid strep/influenza A/B: negative
6. Rheumatoid factor: normal
7. Blood/nasal/stool culture: pending
8. RSV, CMV, EB virus: pending
IMAGING:
CXR: Bilateral peribronchial thickening, most likely 2/2 viral inflammatory
disease
Abdominal U/S: Normal limited visualization |
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