小兒發燒當『感冒』 原來是『腎臟發炎』
<p class="MsoNormal" align="center" style="text-align:center"><b><span style="font-family:"新細明體","serif";mso-ascii-font-family:Calibri;
mso-hansi-font-family:Calibri">小兒發燒當『感冒』</span> </b><b><span style="font-family:"新細明體","serif";mso-ascii-font-family:Calibri;
mso-hansi-font-family:Calibri">原來是『腎臟發炎』</span><span lang="EN-US"><o:p></o:p></span></b></p>
<p class="MsoNormal"><span style="font-family:"新細明體","serif";mso-ascii-font-family:
Calibri;mso-hansi-font-family:Calibri">健康醫療網</span><span lang="EN-US">/</span><span style="font-family:"新細明體","serif";mso-ascii-font-family:Calibri;mso-hansi-font-family:
Calibri">鄭人豪整理報導</span><span lang="EN-US"> <o:p></o:p></span></p>
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<p class="MsoNormal"><span style="font-family:"新細明體","serif";mso-ascii-font-family:
Calibri;mso-hansi-font-family:Calibri">一位一歲四個月大的小妹妹，日前因高燒不退至臺北市立聯合醫院忠孝院區就診。小兒科主治醫師楊雅淇追溯該次病史說明：該名病患出現輕微咳嗽、流鼻水約一週，剛開始曾發燒三天，之後已退燒。但幾天後再度出現發燒，且為攝氏</span><span lang="EN-US">40</span><span style="font-family:"新細明體","serif";mso-ascii-font-family:
Calibri;mso-hansi-font-family:Calibri">度的高燒，咳嗽流鼻水依舊不明顯。</span><span lang="EN-US"><o:p></o:p></span></p>
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<p class="MsoNormal"><span style="font-family:"新細明體","serif";mso-ascii-font-family:
Calibri;mso-hansi-font-family:Calibri">經住院詳細檢查才發現有膿尿（尿中白血球數增加），為大腸桿菌的泌尿道感染。腎臟超音波檢查已可見因發炎而異常腫大的雙側腎臟（急性腎盂腎炎）。使用適當抗生素治療之下仍持續發燒，經電腦斷層掃描證實為急性細菌性腎炎（</span><span lang="EN-US">lobar nephronia)</span><span style="font-family:"新細明體","serif";
mso-ascii-font-family:Calibri;mso-hansi-font-family:Calibri">。</span><span lang="EN-US"><o:p></o:p></span></p>
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<p class="MsoNormal"><span style="font-family:"新細明體","serif";mso-ascii-font-family:
Calibri;mso-hansi-font-family:Calibri">楊雅淇解釋，此為一種較急性腎盂腎炎更嚴重的腎實質發炎，形同腎臟膿瘍的前期變化。所幸經抗生素完整治療三週後痊癒，後續追蹤亦無復發。</span><span lang="EN-US"><o:p></o:p></span></p>
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<p class="MsoNormal"><span style="font-family:"新細明體","serif";mso-ascii-font-family:
Calibri;mso-hansi-font-family:Calibri">她表示，兒童泌尿道感染的發生率於一歲以前以男嬰為多，因男性泌尿系統發生先天畸形的機會較高。於一歲以後女生為多，因女性尿道較短，容易有上行性感染。</span><span lang="EN-US"><o:p></o:p></span></p>
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<p class="MsoNormal"><span style="font-family:"新細明體","serif";mso-ascii-font-family:
Calibri;mso-hansi-font-family:Calibri">以該個案為例，嚴重到合併急性細菌性腎炎（</span><span lang="EN-US">lobar nephronia</span><span style="font-family:"新細明體","serif";
mso-ascii-font-family:Calibri;mso-hansi-font-family:Calibri">），若無適當治療，將有可能進展形成腎臟膿瘍甚至敗血症而危即生命。急性細菌性腎炎治療應先採適當注射型抗生素，待發燒緩解二至三天後，改成口服劑型抗生素，療程總共為期三週。治療期間不足有可能導致治療失敗或復發。除非合併泌尿道結構上的異常，否則很少需要外科手術治療。反之，若進展成腎臟膿瘍，則有可能需要外科手術引流。</span><span lang="EN-US"><o:p></o:p></span></p>
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<p class="MsoNormal"><span style="font-family:"新細明體","serif";mso-ascii-font-family:
Calibri;mso-hansi-font-family:Calibri">楊雅淇強調，小兒發燒若無明顯其他症狀（如：咳嗽、流鼻水、嘔吐或拉杜子），在使用抗生素前，應先檢查尿液以排除小兒泌尿道感染的可能。適當的抗生素治療予以足夠療程，輔以影像學檢查，有助於小兒急性細菌性腎炎的治癒與避免復發。</span><span lang="EN-US"><o:p></o:p></span></p>
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<p class="MsoNormal"><span style="font-family:"新細明體","serif";mso-bidi-font-family:
細明體">想知道更多</span><span lang="EN-US" style="font-family:"新細明體","serif";mso-bidi-font-family:
Calibri">?</span><span style="font-family:"新細明體","serif";mso-bidi-font-family:
Calibri">請上健康醫療網</span><span style="font-family:"新細明體","serif";mso-bidi-font-family:
細明體">（</span><span lang="EN-US" style="font-family:"新細明體","serif";mso-bidi-font-family:
Calibri">www.healthnews.com.tw</span><span style="font-family:"新細明體","serif";
mso-bidi-font-family:細明體">）</span><span lang="EN-US"><o:p></o:p></span></p>
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