DOC

Clinical analysis of 116 cases of rubella in children_1346

By Carmen Lawson,2014-10-30 14:16
7 views 0
Clinical analysis of 116 cases of rubella in children_1346

Clinical analysis of 116 cases of rubella in children

     Key Words rubella

     Rubella by Rubella virus (RV)-induced acute respiratory infection. Since China

    began in 1981, rubella vaccination of domestic - combined live attenuated mumps

    vaccine since its incidence rate dropped significantly. According to the Ministry of Health released the epidemic, in 2007 only 2 of 7 weeks the number of reported cases of rubella was significantly higher than the previous 2 years ago. Are treated in our

    hospital 116 cases of children with rubella incidence and clinical features of reports are as follows.

     A clinical data

     1.1 General Information

     2007-01 ~ 2007-03 rubella among children hospitalized in our hospital a total of 116 cases, male 80 cases, female 36 cases; aged 1 to 14 years in 29 cases, 15 to 18 years of age 87 cases. 92 patients had a clear history of exposure to rubella. This group of five cases of children with rubella vaccination history.

     1.2 Diagnostic Criteria

     Prodromal symptoms before the rash, systemic rapid progress of the rash, upper respiratory tract inflammation and occiput, ears, neck lymph node swelling, pain, reduced white blood cell count, combined with epidemiological history, as the main basis for diagnosis of this disease [1 ].

     1.3 Clinical features

     Have a skin rash and swollen lymph nodes; there were 116 cases of fever (100%), pharyngeal hyperemia were 80 cases (68.9%), headache in 7 cases (6.0%), cough, sputum, 21 cases (17.0%), pharynx pain in 49 cases (42.2%), joint pain in 25 cases (21.6%), skin itching 55 cases (47.4%), rhinorrhea in 22 cases (18.9%), skin bleeding points, 36 cases (31.0%).

     1.4 Laboratory tests

     116 cases of the following checks are conducted.

     1.4.1 routine blood test

     This group of cases, 53 cases (45.7%) WBC reduced, 97 cases (83.6%), elevated white blood cell count, 8 cases (6.9%) decline in platelet count.

     1.4.2 Urinalysis

     61 cases (52.6%), urinary protein increased in 18 cases (15.5%), urine occult blood

    positive (except for other interference have been factors).

     1.4.3 Serum biochemical examination

     Elevated alanine aminotransferase of 46 cases (39.7%), up to 480 U / L; aspartate aminotransferase enzymes 60 cases (51.7%), up to 564 U / L; total bilirubin l High 15 cases (12.9%), up to 34.2 μmol / L; myocardial enzyme abnormalities 86 cases (74.1%). Reposted elsewhere in the paper for free download http://

     1.4.4 Serum IgM anti-rubella virus antibody detection

     116 cases of illness in children 1 to 2 weeks after the follow-up detection of anti-

    rubella virus antibody IgM, 108 cases (93.1%) positive.

     1.4.5 ECG

     49 cases (42.2%), myocardial ischemia or arrhythmias or other abnormal changes.

     1.5 Treatment and prognosis

     I Qingrejiedu traditional Chinese medicine treatment of liver damage were treated to the Liver, heart injuries to nutrition, cardiac treatment, there is inflammation to the anti-infection treatment, treatment, 3 ~ 5 d are able to control the progression of the disease, the average number of hospital days, 7.3 d, compared with the prognosisWell.

     2 Discussion

     Age of onset of patients in this group: 1 ~ 14 years of age accounted for 25%, 15 ~ 18 years of age accounted for 75%. Right to know the previous rubella occurs in children

    are different. Rubella age of onset of an upward trend in adults than children have a higher incidence of England in 1996, a rubella epidemic shows that adult males are susceptible [2]. Clinical rubella is a red maculopapular rash, occiput posterior, neck, ears swollen lymph nodes, accompanied by fever, etc. characterized by mild systemic symptoms. The patients do not appear serious complications, its clinical features: ?

    heat-way long, hot peak height. Children in this group are fever, body temperature as high as 40.5 ?, heat range of up to 8 d. ? rash long time. In this group were 116 cases

    of children with varying degrees of skin rash, rash on the course of the first 1 ~ 4 d, a

    rash of pale red maculopapular rash, rash in order to face ? trunk ? limbs, there are 77 cases (66.4%), palms and plantar skin rash, skin rash duration of 2 ~ 10 d, the average range for the rash 5.6 d, significantly higher than those generally considered

    the 3 d. ? in this group 55 cases (47.4%) in the withdrawal period of a mild skin rash itching, persistent 1 ~ 2 d after the mitigation. 36 cases (31.0%) in the back and bilateral axillary appeared cord-like bleeding in the skin spots, men significantly more

    than females. Bleeding in the skin is caused due to rubella virus antigen-antibody

    complex caused by the upper dermis due to increased capillary permeability, but also may be related to a decline in platelets [3]. ? 25 were made in a rash during the

    transient joint pain, many involving the knee or wrist joints, adolescent women are more common, more because the virus by directly attacking the joint cavity or the immune response caused by the majority in 3 ~ 7 d to disappear within the [4]. ? liver,

    heart, kidney and other organ injury heavier, abnormal liver function appear in the course of the disease more than 5 d or so, some children are fatigue, loss of appetite and other symptoms. 42.2% of the children with abnormal electrocardiogram, myocardial

    enzymes exception of 86 cases (74.1%). There has been any abnormal urine occult blood and protein in those. ? lack of rubella in the clinical diagnosis of early, specific and sensitive diagnostic tests and different reagent positive rate is also different. IgM anti-rubella virus antibodies in early detection of disease-positive rate is low, still can

    not meet the clinical requirements, which mainly rely on clinical diagnosis. But a patient 1 week after anti-rubella virus antibody IgM positive rate is high, which is the literature [5] reported that the same can be used as such as with measles and drug eruption phase identification basis. Many countries rubella vaccine into national immunization programs, some developed countries has been the eradication of rubella as a strategic objective. Rubella should attract the community, to step up publicity and timely patient isolation.

     References

     [1] Peng Wenwei. Infectious diseases [M]. 6 version. Beijing: People's Medical

    Publishing House ,2004:58-60.

     [2] Plotkin SA, Katz M, Cordero JF. The eradication of rubella [J]. JAMA ,1999,281:561-562.

     [3] LI Meng-Dong. Practical epidemiology [M]. 3 version. Beijing: People's Medical Publishing House ,2005:67-72.

     [4] Bennett, Plum. Cecil Textbook of Medicine 20th ed. Philadelphia: WB [J]. Saurders ,1999:940-942.

     [5] Luolan Mei, Xin-Chang Luo, Yun Gong. Serological rubella outbreak detection [J]. Chinese Journal of Health Inspection, 2005,15 (6): 764. Reposted elsewhere in the paper for free download http://www . hi138.com

Report this document

For any questions or suggestions please email
cust-service@docsford.com