超乎常见病因：新生儿发热与血氧饱和度下降
Beyond the Usual Suspects: Neonatal Fever and Desaturation.
作者信息
Doležalová Karolína, Kodetová Jana, Klabusayová Eva, Svobodová Jana, Karmazín Karel, Tkadlec Pavel, Kopecká Emília, Helešic Jan
机构信息
Clinic of Paediatrics of the First Faculty of Medicine, Thomayer University Hospital, Charles University, Prague, Czech Republic.
Department of Paediatric Anaesthesiology and Intensive Care Medicine, University Hospital Brno and Faculty of medicine, Masaryk University, Brno, Czech Republic.
出版信息
Pediatr Pulmonol. 2025 Sep;60(9):e71291. doi: 10.1002/ppul.71291.
BACKGROUND
We report a 1-month-old infant admitted with fever, dyspnea, and desaturation after an unmonitored pregnancy in a migrant family. The patient rapidly required mechanical ventilation. Laboratory parameters were markedly elevated, suggesting an infectious etiology.
METHODS
The clinical course is described with emphasis on diagnostic challenges, including imaging, laboratory findings, and the stepwise process of differential diagnosis.
RESULTS
After common etiologies were excluded, rarer causes were considered. The final diagnosis was established through integration of clinical assessment, radiological imaging, laboratory data, and microbiological testing.
CONCLUSION
In neonates with fever and respiratory distress, RSV bronchiolitis is usually the first consideration. If excluded, clinicians must remain alert to less frequent etiologies. This case underscores the importance of a broad differential diagnosis in infants with acute respiratory compromise.
背景
我们报告了一名1个月大的婴儿，该婴儿来自一个移民家庭，其母亲孕期未受监测，婴儿因发热、呼吸困难和血氧饱和度下降入院。患者很快就需要机械通气。实验室检查参数显著升高，提示存在感染性病因。
方法
描述了该患者的临床病程，重点强调了诊断方面的挑战，包括影像学检查、实验室检查结果以及鉴别诊断的逐步过程。
结果
排除常见病因后，考虑了更罕见的病因。最终诊断是通过综合临床评估、放射影像学检查、实验室数据和微生物学检测得出的。
结论
对于发热和呼吸窘迫的新生儿，呼吸道合胞病毒细支气管炎通常是首要考虑的疾病。如果排除该病因，临床医生必须警惕不太常见的病因。本病例强调了对急性呼吸功能不全婴儿进行广泛鉴别诊断的重要性。
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