背景:水痘是一种非常常见的儿童传染病。它通常是良性的,但是会导致致命的并发症.我们的研究旨在根据儿科急诊科的咨询描述水痘的临床和治疗概况。确定儿科住院水痘病例的发生率,以进行补充管理,并明确住院患者水痘并发症的发生率。
方法:我们进行了为期12个月的回顾性描述性队列研究。它发生在穆罕默德六世大学医院母婴医院的儿科和儿科急诊科,穆罕默德一世大学,在Oujda,摩洛哥。
结果:我们收集了120例水痘病例。患者的平均年龄为4.5岁。最常见的年龄范围是4-6岁(69%)。男性占主导地位。咨询儿科急诊科的原因是65%的病例出现发热性皮疹。儿科紧急情况的治疗主要是对症治疗。11%的病例使用抗生素治疗病灶的双重感染。因复杂和/或严重水痘而住院的人数为17例。中位年龄为6.3岁。大多数儿童(82%)具有免疫缺陷,18%具有免疫能力。16例患者存在潜在危险因素。大多数住院患者(47%)注意到感染性皮肤和软组织并发症。它们主要表现为皮肤再感染和一般健康状况的改变(41%)。神经系统并发症排名第二(23%)。大多数是高热惊厥(17%)。发现1例支气管肺并发症。没有血液学,消化性,肾,或注意到心脏并发症。88%的住院病例采用静脉抗病毒治疗。选择的药物是阿昔洛韦。53%的病例使用抗生素治疗。无患者接受皮质类固醇治疗。我们患者的中位住院时间为14天。在100%的情况下,进化是有利的。
结论:水痘仍然是儿童的良性疾病,很少导致住院。然而,合并症或有危险因素的儿童可能会出现并发症。将水痘疫苗引入国家免疫计划可以大大减少在不久的将来住院的儿童人数。
BACKGROUND: Varicella is a very common childhood infectious disease. It is generally benign, but it can lead to fatal complications. Our study aimed to describe the clinical and therapeutic profile of varicella based on consultations in the pediatric emergency department, to determine the incidence of hospitalized varicella cases in the pediatric department for complementary management, and to specify the incidence of varicella complications in hospitalized patients.
METHODS: We conducted a retrospective descriptive cohort study over 12 months. It took place in the pediatrics and pediatric emergency departments of the Mother-Child Hospital of the Mohammed VI University Hospital, Mohammed I University, in Oujda, Morocco.
RESULTS: We collected 120 cases of varicella. The mean age of patients was 4.5 years. The most common age range was 4-6 years (69%). Males predominated. The reason for consulting the pediatric emergency department was a febrile rash in 65% of cases. Treatment in pediatric emergencies was mostly symptomatic. Antibiotic treatment for superinfection of lesions was used in 11% of cases. The number of hospitalizations due to complicated and/or severe varicella was 17 cases. The median age was 6.3 years. Most of the children (82%) were immunodeficient and 18% were immunocompetent. Sixteen patients had underlying risk factors. Infectious skin and soft tissue complications were noted in most hospitalized patients (47%). They were mainly presented by cutaneous reinfections with alteration of general health (41%). Neurological complications ranked second (23%). The majority were febrile convulsions (17%). One case of bronchopulmonary complication was noted. No hematological, digestive, renal, or cardiac complications were noted. Intravenous antiviral treatment was used in 88% of hospitalized cases. The drug of choice was acyclovir. Antibiotic therapy was used in 53% of cases. No patient received corticosteroid therapy. The median length of hospitalization for our patients was 14 days. The evolution was favorable in 100% of cases.
CONCLUSIONS: Varicella remains a benign disease in children, rarely leading to hospitalization. However, complications may develop in cases of comorbidity or children with risk factors. The introduction of the varicella vaccine into the national immunization program could considerably reduce the number of children hospitalized in the near future.