Freedman Stephen B, Reed John, Burwen Dale R, Wise Robert P, Weiss Amy, Ball Robert
Division of Pediatric Emergency Medicine, Department of Pediatrics, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada.
J Pediatr. 2005 Nov;147(5):640-4. doi: 10.1016/j.jpeds.2005.06.009.
To describe the features of transient bulging fontanelle (TBF) after vaccination.
We searched the Vaccine Adverse Event Reporting System database for reports describing bulging fontanelle. We defined a definite TBF case as a patient with a bulging fontanelle, normal neuroimaging and cerebrospinal fluid analysis, and absence of a depressed level of consciousness, focal neurologic findings, or identified cause. Follow-up had to reveal normal development. Probable cases lacked either lumbar puncture or neuroimaging or both but met all other criteria.
We identified 18 patients with definite or probable TBF. The median age at presentation was 4.5 months, interval from vaccination to symptom onset was 18 hours, and time to resolution was 3 days. Fifteen children were febrile.
We cannot conclude that vaccines cause TBF. Further controlled studies are necessary. Even if further research verifies TBF as a rare side effect, immunization benefits would still vastly outweigh this hypothetical risk. However, confirmation of a vaccine association could modify the management of infants who develop TBF after immunizations.
描述疫苗接种后短暂性囟门隆起（TBF）的特征。
我们在疫苗不良事件报告系统数据库中搜索描述囟门隆起的报告。我们将确诊的TBF病例定义为囟门隆起、神经影像学和脑脊液分析正常、意识水平无降低、无局灶性神经系统体征或未发现病因的患者。随访必须显示发育正常。可能病例缺少腰椎穿刺或神经影像学检查或两者均缺，但符合所有其他标准。
我们确定了18例确诊或可能的TBF患者。就诊时的中位年龄为4.5个月，从接种疫苗到症状出现的间隔时间为18小时，症状缓解时间为3天。15名儿童发热。
我们不能得出疫苗导致TBF的结论。需要进一步的对照研究。即使进一步研究证实TBF是一种罕见的副作用，免疫接种的益处仍将大大超过这种假设的风险。然而，疫苗关联的确认可能会改变免疫接种后发生TBF的婴儿的管理方式。
