每日一题_2024.12.07

A previously healthy 10-year-old boy was brought to the pediatric emergency department with a 4-day history of progressively worsening bruising around the eyelids. Four weeks prior, he developed a dry cough, which had intensified over the previous week. The patient was up to date on routine vaccinations and had no history of trauma or bleeding disorders. On physical examination, ecchymosis was noted on the eyelids, along with subconjunctival hemorrhages in both eyes. A complete ophthalmologic examination was otherwise normal. Which of the following is the most likely etiology of the patient’s symptoms and findings?一个之前健康的10岁男孩被带到儿科急诊室，他有4天逐渐加重的眼周瘀伤史。四周前，他开始出现干咳，过去一周咳嗽加剧。患者按时接种了常规疫苗，没有外伤或出血性疾病史。在体格检查中，注意到眼睑上有瘀斑，双眼都有结膜下出血。其他眼科检查均正常。以下哪项最有可能是患者症状和体征的最可能病因？

A. Acute lymphoblastic leukemia急性淋巴细胞性白血病

B. Influenza流感

C. Inhaled foreign body吸入异物

D. Leptospirosis钩端螺旋体病

E. Pertussis百日咳

答案解析：

从鼻咽拭子样本中进行的聚合酶链反应检测对百日咳鲍特菌呈阳性。确诊为因百日咳引起的眼睑瘀斑和结膜下出血。在百日咳（也称为百日咳）中，当由于剧烈的咳嗽发作导致静脉压力增加时，眼睛及其周围的小血管可能会破裂。剧烈咳嗽的其他并发症包括肋骨骨折、气胸和晕厥。

正确答案：E