Objective The most common childhood convulsive disorder happens to be febrile seizure (FS), which is an important health problem leading to economic burden and parental anxiety. Further investigation into the etiological causes of FS will guide us for appropriate measures during the follow-up period. The aim of study is to identify the percentage of viral and bacterial pathogens in the etiological causes of children with FS, and also if there is any difference between simple and complex FSs.

Methods This prospective study randomly enrolled 100 pediatric patients with FS between January 2017 and July 2017. Nasopharyngeal swabs were obtained from all children at presentation. The respiratory panel was performed with a multiplex real-time polymerase chain reaction method to detect the 21 most common viruses. A complete blood count, absolute neutrophil count, absolute lymphocyte count, C-reactive protein, erythrocyte sedimentation rate, procalcitonin, blood culture, throat culture, urine analyses, urinary culture, and stool tests analysis were performed in all the patients.

Results During the study period, at least one virus was detected in 87% of patients. Bacterial agents were detected in only 13% of patients. Coinfections of the viruses and bacterial pathogens were found in 24% of patients. The most frequently detected virus was influenza A (Inf A) (18%), followed by rhinovirus (12%). Coinfections of the viruses and bacterial pathogens, mixed viral infections, and Inf A were common in children who experienced complex FS. Inf A was detected in 16% of patients with simple FSs and 30% of patients with complex FSs and a significant difference between them (p < 0.01).

Conclusion The results of this study showed that respiratory viral and bacterial pathogens are important in the etiology of FS in children. It is considered that complex FSs may be triggered by Inf A. The fact is viral pathogens are very common; therefore, antibiotics must be carefully prescribed. These results also draw attention to the use of the quadrivalent influenza vaccine in the prevention of FS related to the flu.

目的 最常见的儿童惊厥症是热性惊厥（FS），这是一个重要的健康问题，导致经济负担和父母焦虑。对 FS 病因的进一步调查将指导我们在随访期间采取适当的措施。研究的目的是确定 FS 儿童病因中病毒和细菌病原体的百分比，以及简单和复杂 FS 之间是否存在任何差异。

方法 本前瞻性研究随机招募了 2017 年 1 月至 2017 年 7 月期间 100 名儿童 FS 患者。从所有儿童就诊时获取鼻咽拭子。呼吸检测组采用多重实时聚合酶链反应方法检测 21 种最常见的病毒。对所有患者进行全血细胞计数、中性粒细胞绝对计数、淋巴细胞绝对计数、C反应蛋白、红细胞沉降率、降钙素原、血培养、咽喉培养、尿液分析、尿培养和粪便检查分析。

结果 在研究期间，87% 的患者中至少检测到一种病毒。仅在 13% 的患者中检测到细菌。在 24% 的患者中发现了病毒和细菌病原体的共感染。最常检测到的病毒是甲型流感 (Inf A) (18%)，其次是鼻病毒 (12%)。病毒和细菌病原体的共同感染、混合病毒感染和 Inf A 在经历复杂 FS 的儿童中很常见。Inf A 在 16% 的简单 FS 患者和 30% 的复杂 FS 患者中检测到，并且它们之间存在显着差异（p  < 0.01）。

结论 本研究结果表明，呼吸道病毒和细菌病原体在儿童 FS 的病因中起重要作用。人们认为复杂的 FSs 可能是由 Inf A 触发的。事实上，病毒病原体很常见；因此，必须谨慎使用抗生素。这些结果也引起人们对使用四价流感疫苗预防与流感相关的 FS 的关注。