临床儿科杂志 ›› 2020, Vol. 38 ›› Issue (9): 682-.doi: 10.3969/j.issn.1000-3606.2020.09.010

• 综合报道 • 上一篇    

儿童脾脓肿1 例报告及文献复习

韩芳, 邹丽萍, 杨光, 王林莉, 石秀玉   

  1. 解放军总医院第一医学中心儿内科(北京 100853)
  • 发布日期:2020-09-17
  • 通讯作者: 石秀玉 电子信箱:shixiuyu@sina.com

Splenic abscess in children: a case report and literature review

 HAN Fang, ZOU Liping, YANG Guang, WANG Linli, SHI Xiuyu   

  1. Department of Pediatrics, The First Medical Center, Chinese PLA General Hospital, Beijing 100853, China
  • Published:2020-09-17

摘要: 目的 总结儿童脓毒症并发脾脓肿的临床特点及治疗。方法 回顾分析1例脓毒症并发脾脓肿患儿的临床 资料,检索中国知网、万方数据知识服务平台、PubMed中的相关文献并进行总结分析。结果 男性患儿,11月龄,以反复 发热为主要表现。血培养示屎肠球菌感染,抗感染治疗效果不理想。腹部超声及磁共振成像示脾脏多发脓肿。经超声引导 下脓肿抽液后患儿仍发热,最终行脾脓肿切除术。手术1周后患儿体温恢复正常。共检索到国内外相关文献15篇,共59例 儿童脓毒症并发脾脓肿病例。临床主要表现为发热、咳嗽、腹痛或腹胀, 4例有基础疾病;其中血培养阳性12例, 4例为球 菌阳性, 8例为杆菌阳性。59例患儿均接受抗感染治疗, 2例同时行抗结核治疗, 1例行脾穿刺, 5例行脾切除术。55例患儿 预后良好, 2例好转, 2例病情反复。结论 儿童脓毒症并发脾脓肿以发热为主要表现,部分患儿有基础疾病,以足量、足 疗程抗感染治疗为主,必要时需行脾脓肿切除术。

关键词:  脓毒症; 脾脓肿; 婴儿

Abstract:  Objective To explore the clinical characteristics and treatment of pediatric sepsis complicated with splenic abscess. Method The clinical data of sepsis complicated with splenic abscess in a child was retrospectively analyzed. Relevant literature in CNKI, Wanfang Database, and PubMed was retrieved and analyzed. Results An 11-month-old boy was mainly characterized by recurrent fever. Blood culture showed Enterococcus faecium infection, and the effect of anti-infection treatment was not ideal. Abdominal ultrasonography and magnetic resonance imaging showed multiple splenic abscesses. After ultrasonic-guided fluid extraction of the abscess, the child still had fever and finally underwent splenic abscess resection. One week after surgery, the child's temperature returned to normal. A total of 15 domestic and foreign literatures were returned by the search, and 59 cases of sepsis complicated with splenic abscess in children were found. The main clinical manifestations were fever, cough, abdominal pain or abdominal distension, and 4 cases had underlying diseases. In them, blood culture was positive in 12 cases, in which 4 were positive for cocci and 8 were positive for bacilli. All the 59 cases were received anti-infective treatment, and 2 cases received antituberculosis treatment at the same time. One case underwent splenocentesis and 5 underwent splenectomy. The prognosis of 55 cases was good, 2 cases were improved and 2 cases had relapse. Conclusion Fever is the main manifestation in sepsis complicated with splenic abscess in children. Some children have underlying diseases, and anti-infection treatment with sufficient quantity and sufficient duration is the main treatment. Splenic abscess resection should be performed when necessary.

Key words: sepsis; splenic abscess; infant