Heulitt M J, Ablow R C, Santos C C, O'Shea T M, Hilfer C L
Pediatric Service, St. Luke's-Roosevelt Hospital Center, New York, NY 10025.
Radiology. 1988 Apr;167(1):135-7. doi: 10.1148/radiology.167.1.3347713.
In the febrile infant less than 3 months old, a chest radiograph is commonly obtained to identify the cause of the fever. The purpose of this study was to evaluate the necessity of obtaining chest radiographs in this population. The clinical records and chest radiographs of 192 febrile infants (greater than 100.5 degrees F, rectal) were reviewed. Nineteen patients had signs of respiratory distress; seven had positive findings on chest radiographs. Of the 173 patients without signs of respiratory distress, five had positive findings on chest radiographs. When chest radiography was considered the gold standard for the presence or absence of pneumonia, findings of respiratory distress on physical examination had a sensitivity of 58% and a specificity of 93% for the detection of pneumonia. The prevalence of positive findings on chest radiographs in febrile infants less than 3 months old was 6%. A chest radiograph should be obtained in febrile infants only when signs of respiratory distress are present.
对于3个月以下的发热婴儿，通常会进行胸部X光检查以确定发热原因。本研究的目的是评估对这一人群进行胸部X光检查的必要性。回顾了192例发热婴儿（直肠温度高于100.5华氏度）的临床记录和胸部X光片。19例患者有呼吸窘迫体征；7例胸部X光片有阳性发现。在173例无呼吸窘迫体征的患者中，5例胸部X光片有阳性发现。当将胸部X光检查视为肺炎有无的金标准时，体格检查中呼吸窘迫的发现对肺炎检测的敏感性为58%，特异性为93%。3个月以下发热婴儿胸部X光片阳性发现的患病率为6%。仅当存在呼吸窘迫体征时，才应对发热婴儿进行胸部X光检查。
