PDF(Pubmed)
Abstract：
Many clinical conditions can cause fever of unknown origin (FUO) in children, but the etiological diagnosis remains challenging despite the variety of inspection methods available at present. This study aims to investigate the effectiveness of droplet digital polymerase chain reaction (ddPCR) in identifying pathogens in children with FUO as a novel application. A 7-month-old boy failed to obtain etiology evidence for his disease through various tests. After collecting peripheral blood for ddPCR analysis, Staphylococcus aureus and Escherichia coli were detected, and Sanger sequencing confirmed the pathogens. During the disease, the child developed septic arthritis and osteomyelitis in the femur. Despite the patient\'s fever being removed, his limb activity improving, and inflammatory biomarkers decreasing, avascular necrosis of the femoral head remained after targeted antibiotic treatment and surgery. If the patient had undergone ddPCR analysis at an early stage, it may be possible to avoid sequelae. ddPCR helps identify pathogens in the diagnosis of children with FUO and could be a promising complementary tool.
摘要：
许多临床状况可导致儿童不明原因发热（FUO），尽管目前有多种检查方法,但病因诊断仍然具有挑战性.这项研究旨在研究液滴数字聚合酶链反应（ddPCR）在FUO患儿中鉴定病原体的有效性。一个7个月大的男孩未能通过各种测试获得有关其疾病的病因证据。收集外周血进行ddPCR分析后，检出金黄色葡萄球菌和大肠杆菌,桑格测序证实了病原体。在疾病期间,这个孩子在股骨出现了化脓性关节炎和骨髓炎。尽管病人的发烧被消除了,他的肢体活动得到改善，炎症生物标志物减少，有针对性的抗生素治疗和手术后股骨头缺血性坏死仍然存在。如果患者在早期进行了ddPCR分析，有可能避免后遗症。ddPCR有助于在FUO儿童的诊断中识别病原体，并且可能是一种有前途的补充工具。
