某三级政府医院收治的小儿钩端螺旋体病的临床分析

Kay-Ann Pabalate-Aquino
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摘要

背景:在菲律宾,钩端螺旋体病是一种季节性但常见和流行的疾病,平均每年有680例病例和40例死亡。病例是由于暴露于受污染的洪水、水或土壤造成的。几项研究表明,男性更容易受到影响,因为他们被认为更多地暴露在户外环境中。就儿科人群而言,早期诊断主要基于临床和流行病学因素。目的:本研究旨在确定小儿钩端螺旋体病的临床特征和预后,并确定与死亡率相关的预后因素。方法:2007年1月至2019年12月在某三级医院进行描述性回顾性研究。对符合世卫组织标准(2003年)钩端螺旋体病诊断的所有病例进行了审查。从图表中提取的数据使用Microsoft Excel进行编码;使用STATA SE 15进行处理和分析以生成所需的输出。结果与结论:本研究共报道85例0 ~ 18岁儿童钩端螺旋体病。钩端螺旋体病主要发生在青少年年龄组的男性中。这种情况全年都有,但主要发生在雨季,这增加了涉水接触受污染水的风险,特别是在纳沃塔斯、马拉邦和通多等城市。平均症状持续时间为3.6天。本研究中最常见的临床表现为发热、胃肠道症状、结膜充血、少尿、小腿压痛和头痛。实验室异常表现为白细胞增多、中性粒细胞增多、血小板增多、尿素氮和肌酐升高、低钾血症和低钠血症。有肺出血的患者与预后不良有显著相关性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Clinical Profile of Pediatric Patients with Leptospirosis admitted at a Tertiary Government Hospital
Background: In the Philippines, Leptospirosis is a seasonal but common and prevalent disease with an average of 680 cases and 40 deaths annually. Cases result from exposure to contaminated flood, water, or soil. Several studies showed that males are more commonly affected, who are believed to be more exposed to the outdoor environment. In terms of pediatric population, early diagnosis is based mainly on clinical and epidemiological factors. Objective: This study was conducted to determine the clinical features and outcomes of pediatric leptospirosis, as well as determine the prognostic factors associated with mortality. Methodology: A descriptive retrospective study was done in a tertiary hospital from January 2007 – December 2019. Review of all cases that satisfy the diagnosis of Leptospirosis by WHO Criteria (2003) was done. The data extracted from the chart were encoded using Microsoft Excel; processed and analyzed using STATA SE 15 to generate the required output. Results & Conclusion: In this 12-year study, a total of 85 cases of leptospirosis in children, aged 0-18 years, were reported. Leptospirosis predominates in males in the adolescent age group. It is noted all year round but noted mostly during the rainy months which increases the risk to exposure to contaminated water through wading, especially in the cities of Navotas, Malabon and Tondo. The mean duration of symptoms was 3.6 days. The most common clinical findings noted in this study were fever, gastrointestinal symptoms, conjunctival suffusion, oliguria, calf tenderness and headache. Abnormal laboratory findings were leukocytosis, neutrophilia, thrombocytosis, elevated BUN and creatinine, hypokalemia and hyponatremia. Significant correlation with poor outcome was found in patients who have had pulmonary hemorrhage.
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