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患儿男,12天。发热、口吐泡沫2天,以新生儿肺炎收入院。查体:T38.2℃,反应差,面色灰暗,呼吸快,口吐白色泡沫,鼻扇,双肺可闻及细小水泡音,心率142次/min,律齐。腹胀,脐带已脱,脐部未见分泌物,神经系统无异常。按新生儿肺炎予以抗感染治疗,病情反较前加重。仔细查体,患儿皮肤大汗,双侧瞳孔缩小,直径0.5mm,怀疑有机磷中毒,但家属否认有机磷接触史。后检查患儿包裹时,发现铺有沙土,并可闻及农药气味。询问沙土来源,家属叙说来自曾施过有机磷农药的棉田附近,遂按有机磷中毒处理,病情很快好转,痊愈出院。
Children male, 12 days. Fever, vomit bubble 2 days to neonatal pneumonia income hospital. Examination: T38.2 ℃, poor response, dark complexion, rapid breathing, vomit white foam, nasal fan, lungs can be heard and small blisters sound, heart rate 142 beats / min, law Qi. Abdominal distension, umbilical cord has been off, umbilical no secretions, no abnormalities in the nervous system. According to neonatal pneumonia to be anti-infective treatment, the condition worsened before the contrast. Careful examination of children with sweaty skin, bilateral miosis, diameter 0.5mm, suspected organophosphate poisoning, but family members denied the history of exposure to organic phosphorus. After checking the package of children, found that paved with sand, and can smell pesticides. Asked about the source of sand, family members narrated from the vicinity of cotton fields where organophosphate pesticides had been applied, then treated organophosphate poisoning, the condition improved quickly and he was discharged.