摘要
Abstract
Objective To analyze the causes of clinical misdiagnosis of cough variant asthma(CVA)in children.Methods The case data of 5 children with misdiagnosed CVA admitted from January 2023 to January 2024 were retrospec-tively analyzed.Results Chronic cough was the main or the only symptom in 5 patients,and irritant dry cough was the main manifestation in 3 patients.There were intermittent fever,nasal congestion,runny nose and other upper respiratory tract infection-like symptoms in 2 patients.Pulmonary auscultation revealed rough breathing sound in 3 patients,and coarse rales in 1 patient.Of 5 patients receiving tests of pure protein derivatives of tuberculin,4 patients were negative and 1 patient was pos-itive.Chest X-ray examination showed thickening and disordered lung texture in 4 patients,and sinus X-ray examination showed increased density in the sinus cavity in 1 patient.Two patients were misdiagnosed with bronchopneumonia,2 patients with upper respiratory tract infection,and 1 patient with chronic sinusitis.After targeted treatment,the effect was not favora-ble.The bronchial dilation test was positive in all patients,the skin allergen test was positive in 3 patients,and the pulmonary function test was abnormal in 5 patients.Combined with the history,symptoms and auxiliary examination results,the diagnosis was CVA in children.Misdiagnosis lasted from 1 to 7 months.After diagnosis,all 5 patients were treated with aerosol inhala-tion of Salbutamol combined with aerosol inhalation of Budesonide suspension,and 1 patient was treated with Montelukast So-dium chewable tablets every night.At 1 to 2 weeks after treatment,the cough was controlled and the pulmonary function was improved or recovered.No recurrence was found at 6-month follow-up.Conclusion The early symptoms of CVA in children are nonspecific and the misdiagnosis rate is high.For children with recurrent chronic cough and persistent cough,doctors should be alert to the possibility of CVA in children,make diagnosis in strict accordance with the diagnosis and treatment guidelines,carefully inquire about the medical history,and perform specific examinations in time to improve the early diagno-sis rate and reduce the misdiagnosis rate.关键词
哮喘,咳嗽变异性/儿童/误诊/支气管肺炎/上呼吸道感染/慢性鼻窦炎/诊断/鉴别诊断Key words
Asthma,cough variability/Children/Bronchopneumonia/Upper respiratory tract infection/Chronic si-nusitis/Misdiagnosis/Diagnosis/Differential diagnosis分类
医药卫生
