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近10年来国外有不少关于婴幼儿隐性菌血症(occult bacteremia)或称意料外的菌血症(unsuspected bacteremia)的报告。这类菌血症病例均为作者在急诊或门诊对发热婴幼儿作非选择性血培养所得,患儿多数是所谓“步入”诊室,仅有轻微的病态而无可查出的感染病灶。从不同作者病例观察资料来看,2岁内发热婴幼儿菌血症的发生率约为4～10%。这个发现给临床上带来了一些实际问题,即这类菌血症有什么临床意义,如何预测和筛选这种隐性菌血症?是否对每一例发热患儿都要作血培养?是否对每一发热小儿都要应用抗生素等。
In the past 10 years, there have been a lot of reports about occult bacteremia or unsuspected bacteremia in infants and young children abroad. These bacteremic cases are all those obtained by non-selective blood culture of fever-prone infants and young children in the emergency or outpatient setting. Most of the children are so-called “walk-in” clinics with only mild pathology and no detectable infectious lesions. According to the observation data of different authors, the incidence of bacteremia in infants and young children aged 2 years old is about 4 to 10%. This discovery has brought some practical clinical problems, namely, what is the clinical significance of such bacteremia, how to predict and screen this recessive bacteremia? Whether for every case of children with fever should be for blood culture? Every fever should be applied antibiotics and other children.