→ SkySlaughter:附議 08/03 23:32
推 chihuahua:附議 08/03 23:36
※ 引述《chihuahua (chihuahua)》之銘言：
<<原始文吃光光>>
: 題目問:典型的表現
: Pertussis is an acute respiratory tract infection that was well described
: initially in the 1500s. Sydenham first used the term pertussis, meaning
: intense cough, in 1670; it is preferable to whooping cough because most
: infected individuals do not “whoop.”
: 但是
: Adenoviral infections are usually distinguishable by associated features,
: such as fever, sore throat, and conjunctivitis.
: [Mycoplasma causes protracted episodic coughing, but patients usually have
: a history of fever, headache, and systemic symptoms at the onset of disease
: as well as more continuous cough and frequent finding of rales on
: auscultation of the chest.]
: 資料來源:Nelson 18 edition
: 這題可以說它沒有清楚的etiology,所以如果是etiology是Mycoplasma infection的話,
: 還是會 [frequent finding of rales on auscultation of the chest]?
: 覆議的請推文 謝謝
Kliegman: Nelson Textbook of Pediatrics, 18th ed.
Chapter 194 – Pertussis (Bordetella Pertussis and Bordetella Parapertussis)
CLINICAL MANIFESTATIONS.
Classically, pertussis is a prolonged disease, divided into catarrhal,
paroxysmal, and convalescent stages. The catarrhal stage (1–2 wk) begins
insidiously after an incubation period ranging from 3–12 days with
nondistinctive symptoms of congestion and rhinorrhea variably accompanied by
low-grade fever, sneezing, lacrimation, and conjunctival suffusion. As
initial symptoms wane, coughing marks the onset of the paroxysmal stage (2–6
wk). The cough begins as a dry, intermittent, irritative hack and evolves
into the inexorable paroxysms that are the hallmark of pertussis. A
well-appearing, playful toddler with insignificant provocation suddenly
expresses an anxious aura and may clutch a parent or comforting adult before
beginning a machine-gun burst of uninterrupted coughs, chin and chest held
forward, tongue protruding maximally, eyes bulging and watering, face purple,
until coughing ceases and a loud whoop follows as inspired air traverses the
still partially closed airway. Post-tussive emesis is common, and exhaustion
is universal. The number and severity of paroxysms escalate over days to a
week and remain at that plateau for days to weeks. At the peak of the
paroxysmal stage, patients may have more than 1 episode hourly. As the
paroxysmal stage fades into the convalescent stage (?2 wk), the number,
severity, and duration of episodes diminish.
所以以典型症狀來看的話，她的呼吸音應該不會是正常的
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