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目的确认2008年5月广州市番禺区1起婴儿手足口病死亡的病因。方法访谈病例发病前后相关知情人,查阅临床病志,对病家开展现场调查和病例主动搜索。采集病例肛拭子、口腔分泌物、鼻腔分泌物、脑脊液,应用逆转录-聚合酶链反应(RT-PCR),检测肠道病毒(EV)的EV71和CA16特异的核酸片段。结果患儿无外出,无接触史,病家及周围卫生条件差。5月1日,患儿发热,手、足及口腔出现散在疱疹,5月5日,出现抽搐、巴氏症阳性、双肺可闻及大量痰鸣音等重症表现,死于脑炎和肺水肿。实验室结果为EV71阳性、Cox A16阴性。结论该患儿为7EV71感染的重症手足口病例,但感染途径未查明。
Objective To confirm the cause of death from hand, foot and mouth disease in infants in Panyu District, Guangzhou City in May 2008. Methods Interview the relevant insiders before and after the onset of the disease, access to clinical signs, on-the-spot investigation and case active search. Samples of anal swabs, oral secretions, nasal secretions and cerebrospinal fluid were collected and the EV71 and CA16-specific nucleic acid fragments of enterovirus (EV) were detected by reverse transcription-polymerase chain reaction (RT-PCR). Results no out of children, no history of contact, sickness and poor hygiene around. May 1, children with fever, hand, foot and oral herpes zoster, May 5, convulsions, positive Papulosis, lungs can be heard and a large number of phlegm and other severe symptoms, died of encephalitis and lungs Edema. Laboratory results for EV71 positive, Cox A16 negative. Conclusion This patient is a severe case of foot-mouth disease with 7EV71 infection, but the infection route was not identified.