儿童布氏杆菌病临床特征和实验室检查特点分析  

Clinical characteristics and laboratory features in children with brucellosis

作　　者：李静[1] 徐文健[1] 王洛平[1] 孟春[1] 方芳[1] 马丽娟[1] 

机构地区：[1]首都儿科研究所附属儿童医院检验中心,北京100020

出　　处：《北京医学》2016年第8期781-784,共4页Beijing Medical Journal

摘　　要：目的探讨儿童布氏杆菌病的临床特征及实验室诊断特点。方法对2011年9月至2015年4月首都儿科研究所附属儿童医院收治的10例儿童布氏杆菌病例的临床特征和实验室检查结果进行回顾分析。结果临床主要表现为发热，部分患儿伴有膝、髋关节疼痛，睾丸痛。体征包括肝、脾、淋巴结肿大。实验室检查患儿血培养布氏杆菌阳性率为100％（10／10），报警时间2．3～3．6d。其中5例患儿同时行骨髓培养，布氏杆菌阳性率为80％（4／5），报警时间1．9～3．7d。布氏杆菌在血平皿上生长缓慢，形成肉眼可见的菌落需36—48h。血常规表现为白细胞分类以淋巴细胞为主，部分伴有贫血和血小板减低。CRP升高和肝脏酶学异常较常见。结论儿童布氏杆菌感染临床特征非特异，与多种疾病临床表现相似，易出现漏诊或误诊。血培养和骨髓培养在疾病早期阳性率高，是诊断该病的金标准。Objective To evaluate the clinical characteristics and laboratory features in children with brucellosis. Methods Clinical cases of 10 children with brucellosis admitted to Capital Institute of Pediatrics from September 2011 to April 2015 were collected. Results Fever, arthralgia were the main clinical manifestations. The physical findings varied, including hepatomegaly, splenomegaly, enlargement of lymph nodes. Blood culture were positive in 100% patients, the positive time was 2.3-3.6 days. Meanwhile, 5 patients performed bone marrow culture and the positive rate was 80%, the positive time was 1.9-3.7 days. Brucellae growth rate was slow on blood Agar. Other laboratory examinations showed that lymphocyte was predominant in the differential counts of WBC, some patients had anemia and thrombopenia at the same time. High level CRP, elevated aminotransferase and aminopherase levels were common. Conclusion Childhood brucellosis has similar clinical manifestations with other diseases. It is easily to be misdiagnosed. Blood and bone marrow cultue are golden standard for the diagnosis of brucellosis.

关 键 词：布氏杆菌 儿童 临床特征 微生物培养 

分 类 号：R725.1[医药卫生—儿科]