Emergency Department, Sant Joan de Deu Hospital, passeig Sant Joan de deu 2 08950, Barcelona, Spain.
Arch Dis Child. 2012 Mar;97(3):239-40. doi: 10.1136/archdischild-2011-300498. Epub 2011 Dec 18.
To determine the prevalence of retinal haemorrhages in infants with pertussis infection with the purpose of clarifying the differential diagnosis of the cases of abusive head trauma.
Prospective study of children aged 15 days to 2 years admitted to our hospital with a diagnosis of pertussis over a period of 4 years (May 2004-May 2008). All children underwent one detailed ophthalmological examination within 72 h of admission. If retinal haemorrhages were detected, further investigation was undertaken to rule out systemic disorder or maltreatment.
35 children with pertussis infection were examined. None was found to have retinal haemorrhages. Therefore, applying Wilson's method, the data suggest with 95% confidence that the true effect estimate for retinal haemorrhage occurring due to symptomatic pertussis infection requiring admission to hospital is no higher than 9.9%.
Pertussis infections are unlikely to cause retinal haemorrhages in children under 2 years of age.
确定百日咳感染婴儿视网膜出血的患病率，以便明确虐待性头部外伤病例的鉴别诊断。
对在我院住院的 4 年间（2004 年 5 月至 2008 年 5 月）被诊断为百日咳的 15 天至 2 岁的儿童进行前瞻性研究。所有儿童均在入院后 72 小时内接受了一次详细的眼科检查。如果发现视网膜出血，则进行进一步检查以排除全身性疾病或虐待。
检查了 35 例百日咳感染儿童，均未发现视网膜出血。因此，应用 Wilson 法，数据表明有 95%的置信度，因需住院治疗的有症状百日咳感染而发生的视网膜出血的真实效应估计值不高于 9.9%。
2 岁以下儿童的百日咳感染不太可能导致视网膜出血。
