Baby crying

Introduction Pediatric crying is a clinical manifestation of pediatric pneumonia. Pneumonia is the most common respiratory disease in children. Infants and young children under 3 years old have more pneumonia in winter and spring, and pneumonia caused by bacteria and viruses is the most common. Children are prone to pneumonia at the time of their birth, usually caused by prenatal and postpartum. The prenatal fetus lives in the uterus filled with amniotic fluid, and hypoxia occurs (such as umbilical cord around the neck, fetal heart changes, abnormal fetal movement), respiratory movements occur and inhaled amniotic fluid, causing aspiration pneumonia; if early water breaks, prolonged labor Or in the process of childbirth, inhalation of bacterial contaminated amniotic fluid or birth canal secretions, easy to cause bacterial pneumonia; if amniotic fluid is contaminated by meconium, inhalation of the lungs can cause meconium aspiration pneumonia.

Cause

Children are prone to pneumonia at the time of their birth, usually caused by prenatal and postpartum. The prenatal fetus lives in the uterus filled with amniotic fluid, and hypoxia occurs (such as umbilical cord around the neck, fetal heart changes, abnormal fetal movement), respiratory movements occur and inhaled amniotic fluid, causing aspiration pneumonia; if early water breaks, prolonged labor Or in the process of childbirth, inhalation of bacterial contaminated amniotic fluid or birth canal secretions, easy to cause bacterial pneumonia; if amniotic fluid is contaminated by meconium, inhalation of the lungs can cause meconium aspiration pneumonia.

The other is neonatal infectious pneumonia. If the child is in contact with a person (such as a cold), the child is easily infected with pneumonia; newborns due to sepsis or umbilical inflammation, enteritis, pneumonia through the blood circulation, this infection can be caused by bacteria; In newborns, pneumonia can also be caused by viruses and other microorganisms.

an examination

Related inspection

Pulmonary perfusion imaging

(1) White blood cell examination: When cell pneumonia is present, the total number of white blood cells increases, which is about 15 to 20 × 109 / L. Severe Staphylococcus aureus pneumonia and influenza bacillus pneumonia, sometimes the total number of white blood cells is reduced. The number of white blood cells in viral pneumonia was normal or decreased, the proportion of lymphocytes increased, and the number of neutrophils did not increase.

(2) The C-reactive protein test increases in bacterial infection, sepsis, etc., and the increase is proportional to the severity of the infection. Viruses and mycoplasma infections do not increase.

Differential diagnosis

Pediatric pneumonia is easily confused with the following diseases:

Bronchitis: systemic symptoms are mild, generally no dyspnea and hypoxic symptoms, the lungs can smell dry rales and medium coarse wet rales, not fixed, often disappear with cough or body position changes.

Acute miliary tuberculosis: sudden onset of children with high fever, chills, general malaise, shortness of breath, cyanosis and other symptoms of systemic poisoning, similar to bronchitis, but the lungs often have no obvious signs, or have a wet rales, scattered in Both lungs are found at the end of inhalation. X-ray findings are also similar to bronchial pneumonia. According to the history of tuberculosis exposure, clinical symptoms, positive tuberculin test, increased erythrocyte sedimentation rate, sputum or gastric lavage fluid can be identified by the characteristics of follow-up observation of tuberculosis and X-ray.

Most cases of caseous pneumonia are produced in children with weak or low resistance. X-ray shows dense deformation in most of the lung segment and even a lobe. The outline is fuzzy, and a relatively transparent liquefied area is usually seen. Even light-transparent voids. Combined with medical history, tuberculin test, etc., easy to identify with bronchial pneumonia.

Bronchial foreign body: history of foreign body inhalation, or history of cough. The clinical is light and heavy, and the duration of the disease varies. Patients with secondary infections may have repeated fever, cough, lung audible and wet rales similar to pneumonia. Sometimes auscultation and tracheal slap sounds may be helpful in diagnosis, but the diagnosis is confirmed by fiber-optic patency.

Bronchiolitis is very similar to acute pneumonia, but the disease is mainly asthmatic. Both lungs can smell a wide range of wheezing sounds and fine wet rales. The children with severe disease have obvious hypoxia. The X-ray only shows that the two lungs have enhanced transmittance, the diaphragm is decreased, and the transient emphysema changes. A few sick children have a little spotty shadow.

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