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Clinical spectrum of intra-abdominal abscesses in children admitted to the pediatric emergency department.
Journal of Microbiology, Immunology and Infection ( IF 4.5 ) Pub Date : 2018-08-09 , DOI: 10.1016/j.jmii.2018.07.003
Chun-Yu Chen , Mao-Jen Lin , Wen-Chieh Yang , Yu-Jun Chang , Feng-Xia Gao , Han-Ping Wu

BACKGROUND To analyze clinical spectrum of intra-abdominal abscesses in children and find helpful clinical parameters could aid physicians in earlier detection and differential diagnosis. METHODS From 2004 to 2011, we retrospectively analyzed 66 pediatric patients, aged 18 years or younger with intra-abdominal abscesses. The data were obtained and studied: demographics, clinical presentations, etiologies, laboratory tests, microbiology, imaging studies, treatment modalities, complications and long-term outcomes. RESULTS There were 66 patients (mean age, 9.27 ± 4.16 years) diagnosed as intra-abdominal abscesses. The two most common presented symptoms were fever and abdominal pain (90.9%; 78.8%, respectively). Most patients presented with leukocytosis (81.8%) and elevated C-reactive protein (CRP) levels (95.5%). In patients with abscesses in solid organs, urine white blood cell counts, nitrate and leukocyte esterase were all significant parameters (all P < 0.05), and urine pH and specific gravity were both lower than those in non-solid organs (P = 0.026; P = 0.043, respectively). Escherichia coli (E. coli) was the most common organism cultured from renal abscess. Streptococcus viridans was the most common organism cultured from liver abscess. Moreover, the two most predominant bacteria in periappendical and intraperitoneal abscesses were E. coli and Bacteroides fragilis. CONCLUSIONS We suggest that primary physicians should keep this disease in mind when children present with predisposing risk factors, fever, abdominal pain, leukocytosis and elevated CRP level. Besides, we recommend the urinary analysis or ultrasonography (US) is valuable in patients with fever and abdominal pain.

中文翻译:

小儿急诊科住院患儿腹腔内脓肿的临床范围。

背景技术分析儿童腹腔内脓肿的临床频谱并找到有用的临床参数可以帮助医生及早发现和鉴别诊断。方法2004年至2011年,我们回顾性分析了66例年龄在18岁以下的小儿腹腔内脓肿患者。获得并研究了数据:人口统计学,临床表现,病因,实验室检查,微生物学,影像学研究,治疗方式,并发症和长期结果。结果共有66例患者(平均年龄为9.27±4.16岁)被诊断为腹腔内脓肿。最常见的两种症状是发烧和腹痛(分别为90.9%; 78.8%)。大多数患者表现出白细胞增多(81.8%)和C反应蛋白(CRP)水平升高(95.5%)。在实体器官脓肿的患者中,尿白细胞计数,硝酸盐和白细胞酯酶都是重要参数(所有P <0.05),尿液的pH和比重均低于非实体器官(P = 0.026; P = 0.026)。 P分别为0.043)。大肠杆菌(E. coli)是从肾脓肿中培养出来的最常见的生物。绿色链球菌是肝脓肿中最常见的生物。此外,阑尾周围和腹膜内脓肿中两个最主要的细菌是大肠杆菌和脆弱的拟杆菌。结论我们建议当儿童出现易感危险因素,发烧,腹痛,白细胞增多和CRP水平升高时,初级医师应牢记这种疾病。除了,
更新日期:2020-04-22
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