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识别类似肺炎病症的策略。

Strategies for recognizing pneumonia look-alikes.

作者信息

Drummond David, Hadchouel Alice, Petit Arnaud, Khen-Dunlop Naziha, Lozach Cécile, Delacourt Christophe, Berteloot Laureline

机构信息

Department of Pediatric Pulmonology and Allergology, University Hospital Necker-Enfants Malades, AP-HP, 149 rue de Sèvres, 75015, Paris, France.

Université de Paris, Paris, France.

出版信息

Eur J Pediatr. 2022 Oct;181(10):3565-3575. doi: 10.1007/s00431-022-04575-9. Epub 2022 Jul 30.

Abstract

Community-acquired pneumonia is a common diagnosis in children. Among the many children whose symptoms and/or chest X-ray is consistent with community-acquired pneumonia, it can be difficult to distinguish the rare cases of differential diagnoses that require specific management. The aim of this educational article is to provide clinicians with a series of questions to ask themselves in order to detect a possible differential diagnosis of pneumonia in children. The value of this approach is illustrated by 13 real clinical cases in which a child was misdiagnosed as having lobar pneumonia. What is Known: • When a lobar pneumonia is diagnosed, an appropriate antibiotic treatment leads to the resolution of the clinical signs in most cases. • However, several diseases can be look-alikes for pneumonia and mislead the practitioner. What is New: • This article provides a new approach to identify differential diagnoses of pneumonia in children. • It is illustrated by 13 real-life situations of children misdiagnosed as having pneumonia.

摘要

社区获得性肺炎是儿童常见的诊断疾病。在众多症状和/或胸部X光与社区获得性肺炎相符的儿童中,很难区分出需要特殊治疗的罕见鉴别诊断病例。这篇教育文章的目的是为临床医生提供一系列问题,以便他们自我询问,从而发现儿童肺炎可能的鉴别诊断。通过13例儿童被误诊为大叶性肺炎的真实临床病例说明了这种方法的价值。已知信息:• 诊断为大叶性肺炎时,适当的抗生素治疗在大多数情况下可使临床症状消退。• 然而,有几种疾病可能貌似肺炎并误导从业者。新内容:• 本文提供了一种识别儿童肺炎鉴别诊断的新方法。• 通过13例儿童被误诊为肺炎的真实病例进行了说明。

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