Misdiagnosis Analysis of Status Asthmaticus in Children (20 Cases)

YANG Xin; LI Xi-hong

doi:10.3969/j.issn.1002-3429.2016.05.010

Abstract：Objective To analyze the clinical characteristics , the misdiagnosis and precautionary measures of status asthmatics ( SA) in children and to raise the clinical awareness of children's SA.Methods Clinical data of 20 misdiagnosed cases out of 52 cases of children's SA were enrolled .The patients were hospitalized in the First Affiliated Hospital of Chengdu Medical School or Second West China Hospital of Sichuan University during January 2009 and July 2015 and their clinical data was retrospectively analyzed .Results The misdiagnosis rate was 38 .5%.17 cases had varying degrees of difficulty in breathing .There were 16 cases without pulmonary wheezing sound and 4 cases with little pulmonary wheezing sound .10 cases were misdiagnosed as arrhythmia , 6 cases were misdiagnosed as pneumothorax , 2 cases were misdiagnosed as severe pneumo-nia and 2 cases were misdiagnosed as epilepsy .The misdiagnosis time was 3.5-16.0 (8.18 ±5.52 ) h.The final diagnosis was based on the history and the clinical presentations .This group met the standards of SA which were formulated by the Soci-ety of Pediatrics of Chinese Medical Association .After intravenous administration of Glucocorticoid and Aminophylline ,β2 re-ceptor agonist atomization , 13 cases had remission in 12 h and 6 cases had relief in 24 h, and one case 5 days later by me-chanical ventilation after invalid conservative treatment for 48 h.Conclusion SA is one of the severe and acute diseases in children.The lung examination often presents "silent lung"and misdiagnosis may occur when possible complications emerge . Clinicians need to raise awareness of the clinical manifestations and complications of SA , collect case history and make neces-sary examinations and comprehensive analysis of the illness .