B****r
发帖数: 1737 | 1 看了三次医生，没有任何进展。可能下周要收入院了。小地方没有儿童医院，也不知道
该不该换个别的医生。恳请大家帮着瞧瞧 （病人情况如下）。万分感谢。
5 yo female with persistent cough x 14 days and fever x 10 days. Fever runs
102-104 F, but does normalize when given motrin or tylenol. Symptom no
improvement after 4 days of Azithromycin. Began to have loose stool /watery
diarrhea for past 3-4 days. She had complained of abdominal pain (mostly
peri-umbilical) intermittently for the past 2-3 weeks. Has a history of
problems with constipation. Slightly decreased PO intake, but still drinking
okay. Still playful when fever weans off by antipyretic. No headache/rash/
eye pain. No joint pain but sometimes complains lower extremities numbness
when she is sitting on the toilet.
No significant PMHx other than inguinal hernia. No significant FHx.
PE: 1+ tonsil without exudates, shotty cervical LN, vague abdominal pain,
otherwise no significant changes.
LAB:
1. CBC diff: Normal WBC, but left shift (no bands); no anemia
2. Elevated ESR (65) and CRP (48)
3. CMP: normal
4. UA: Trace blood, otherwise normal
5. Rapid strep/influenza A/B: negative
6. Rheumatoid factor: normal
7. Blood/nasal/stool culture: pending
8. RSV, CMV, EB virus: pending
IMAGING:
CXR: Bilateral peribronchial thickening, most likely 2/2 viral inflammatory
disease
Abdominal U/S: Normal limited visualization | m******r
发帖数: 1904 | 2 多种证据支持病毒感染，如果是这样，早期抗生素用处不大，主要还是支持治疗为主。
帮您转医疗实践版，看看前辈们的看法
Blessing | s*********e
发帖数: 120 | | l*********2
发帖数: 16 | 4 Like some virus infection, ab pain might caused by the LNs inflammation.
At this point, drink plenty of fluid, Emergen VitC, and rest well. Also some
Chinese herb medicine for anti-inflammation(清热解毒) | t*********t
发帖数: 92 | |
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