Changes of clinical characteristics of hospitalized children with fever and cervical lymphadenopathy in general hospital
10.3760/cma.j.issn.1673-4912.2022.02.007
- VernacularTitle:综合医院发热伴颈部淋巴结肿大住院儿童临床特征变迁分析
- Author:
Guangna CAO
1
;
Hui LIU
;
Shan LU
;
Yanxia YOU
;
Yan XING
Author Information
1. 北京大学第三医院儿科 100191
- Keywords:
Fever;
Cervical lymphadenopathy;
Children
- From:
Chinese Pediatric Emergency Medicine
2022;29(2):109-113
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To analyze the etiology and clinical characteristics of hospitalized children with fever and cervical lymphadenopathy in general hospital, so as to provide evidence for clinical diagnosis and treatment.Methods:Fifty-six children with fever and cervical lymphadenopathy in the pediatric ward at the Peking University Third Hospital from January 1, 2016 to December 31, 2020 were analyzed retrospectively.They were divided into<6 years old group( n=33) and ≥6 years old group( n=23) according to their ages.The differences of etiological composition among different age groups were analyzed.According to the causes of disease, the cases were divided into infectious disease group and non-infectious disease group.The dynamic changes of etiological composition year by year were analyzed, and the laboratory examination and treatment of children were summarized. Results:Among the 56 cases, 53 cases were confirmed, including 17 cases(30.36%)of acute suppurative lymphadenitis, 13 cases(23.21%)of Kawasaki disease, 13 cases(23.21%)of infectious mononucleosis, seven cases(12.50%)of respiratory tract infection and three cases(5.36%)of histiocytic necrotizing lymphadenitis.As for Kawasaki disease, there were significantly more children in the <6 years old group than that in the ≥ 6 years old group( P=0.005). During the past 5 years, the proportion of infectious diseases have decreased year by year, and the proportion of non-infectious diseases have increased year by year.The difference was statistically significant( χ2=11.443, P=0.022). The levels of leukocyte, neutrophil and quick C-reactive protein in children with non-infectious diseases were higher than those in infectious disease group.The differences were statistically significant(all P<0.05). Among the 56 children, 54 cases(96.4%)were treated with antibiotics.There was no significant difference in the usage rate of antibiotics between the infectious disease group and the non-infectious disease group( χ2=0.019, P=0.890). Conclusion:The main diseases of fever with cervical lymphadenopathy in pediatric inpatients in general hospital are acute suppurative lymphadenitis, Kawasaki disease and infectious mononucleosis, respectively.During the past 5 years, the proportion of non-infectious diseases has increased year by year, but the usage rate of antibiotics has not declined.Clinical attention should be paid to the rational use of antibiotics.
