Red Net Moment, February 28th (correspondent Luo Lefuqing) Nuan Nuan (pseudonym), a one-and-a-half-year-old child who lives in Shaoyang, caught cold more than a month ago He developed fever, vomiting, fatigue and other discomforts. After being treated in many local hospitals, his condition did not improve, and then he developed binocular strabismus, confusion, screaming and other abnormal manifestations. His parents urgently referred him to Changsha Central Hospital (affiliated to South China University). Changsha Central Hospital) Children’s Tuberculosis Department, after examination, it was considered to be tuberculous meningitis. The cause of the child’s illness is likely to be infected when living with his grandfather who has tuberculosis.
Nuan Nuan’s mother introduced that Nuan Nuan is now one and a half years old. In June last year, both herself and her husband went to work in other places, and Nuan Nuan stayed in her hometown to be taken care of by her grandparents. My grandfather was diagnosed with tuberculosis three years ago, but after taking the medicine to control it, he did not re-examine and continue to take the medicine. “Nuan Nuan has been following their life without any abnormality, but at the end of last year, my grandmother found that the child began to intermittently have symptoms such as fever and cough.” At first, I thought that the child was caused by a cold, but after taking cold medicine, the effect was not obvious. After two weeks of treatment intermittently in the local hospital, Nuan Nuan, who was already thinner than children of the same age, became thinner and thinner, with poor mental appetite, and abnormal reactions such as disturbance of consciousness and screaming. The parents hurriedly took the child Go to Changsha for treatment.
“When the child was brought in, he had symptoms such as vomiting, disturbance of consciousness, weight loss and fatigue, tremors of hands and feet, etc. The relevant examinations were perfected. The PPD skin test result was strongly positive, and the head CT examination showed supratentorial brain volume. The water is accompanied by interstitial cerebral edema, and the ventricle is obviously dilated. Combined with the clinical manifestations, it is considered that the child suffers from tuberculous meningitis.” Zhang Xiaofo, deputy director and deputy chief physician of the Children’s Medical Center of Changsha Central Hospital, introduced that the child’s short period of time after admission Within hours, the condition progressed rapidly, and there were intracranial hypertensive crisis such as unequal pupils, severe disturbance of consciousness, slow heart rate, and elevated blood pressure. The top priority in the rescue and treatment of children must be to relieve intracranial hypertension. The department immediately contacted Fu Xing, deputy chief physician of neurosurgery, for consultation. After discussion, it was decided to immediately perform outdoor drainage + Ommaya capsule implantation for the child.
Zhang Xiaofo led the medical team to formulate a careful treatment plan for the child again, monitoring vital signs, respiratory and circulatory support, combining effective anti-tuberculosis, maintaining electrolyte balance, and injecting Ommaya into the capsule… After two days of careful treatment With proper treatment and meticulous care, the child’s consciousness gradually became awake, the intracranial hypertension was relieved, and the cerebrospinal fluid index was significantly improved. At present, the child’s spirit has improved significantly and his body temperature is normal. He has been transferred to the Children’s Tuberculosis Department for further treatment.
“Tuberculosis is an infectious disease. When pulmonary tuberculosis patients cough, expectorate, sneeze or speak loudly, they will disperse droplets with tuberculosis into the air. Inhalation of the surrounding people will cause infection. The grandfather has tuberculosis. It should be that he did not take good home protection when he was recovering, and he did not regularly monitor the recovery of tuberculosis infection, so the child was infected with the disease. After the human body is infected with tuberculosis, the lungs They are most vulnerable to infection, usually with symptoms such as cough, fever, night sweats, etc. If tuberculosis is not treated in a timely and effective manner, it may lead to tuberculosis infection in other parts of the body.” Director Zhang Xiaofo introduced that tuberculous meningitis is the most dangerous of tuberculosis. The symptoms of tuberculous meningitis in children are not typical, the disease progresses rapidly, and the average disease duration from onset to death is only 3-6 weeks. Its main clinical manifestations are fever, night sweats, weight loss, vomiting, lethargy, restlessness and even convulsions.
What should I do if my family members have tuberculosis? Director Zhang Xiaofo introduced: If a family member or close relative or neighbor suffers from pulmonary tuberculosis, especially if a breastfeeding mother has open tuberculosis, you should take your child to a specialist hospital as soon as possible to complete the relevant examination. After children suffering from tuberculosis, about 40% have respiratory symptoms such as cough and shortness of breath; 30%-60% have high fever or irregular low fever at the time of onset; in addition, indigestion, loss of appetite, easy crying, lack of energy, Symptoms such as poor sleep. Therefore, if the child continues to have the above symptoms for more than a week, he should go to the hospital in time to exclude the possibility of tuberculosis. Tuberculosis in children is mostly accompanied by lymphadenopathy throughout the body, especially in the neck. If the child has the above-mentioned symptoms, and at the same time feels isolated or bead-like enlarged lymph nodes in the neck, under the jaw, armpit, etc., the possibility of tuberculosis is high and should be checked immediately to a specialist hospital.
If there are tuberculosis patients at home during the excretion period, they should live alone, and the tableware should be reserved for special persons. The daily opening of the window in the room is the simplest and most effective air disinfection method. For disinfection, the used sheets and bedding can be disinfected by exposure to the sun for 6 hours. If you need to directly contact the bacteria, you should wear a mask; patients should not spit, and the secretions from the mouth and nose should be wrapped in toilet paper and burned to avoid infection.