The Clinical Analysis Of Exanthem Subitum With Neutropenia

Objective: Provide references to clinical diagnosis and treatment byanalyzing the clinical features of children’s exanthem subitum withneutropenia.Methods:1. Analyzed the medical records of40patients with exanthem subitumwith neutropenia from January2010to June2011retrospectively.Thecontrol group was randomly sampled from40patients with upper respiratorytract infection with neutropenia, whose age distribution was equivalent to thestudy group.2. Used SPSS19.0to sort data and analyzed the data with chi-square test,t-test and analysis of variance (ANOVA).(P <0.05with a statisticalsignificance)Results:1. The age distribution and gender ratio between the study group andthe control group had no significant difference (P>0.05). In the study group,24patients were male while16were female;20patients were under1yearold,20patients were between1to3years old. 2. The onset time between the study group and the control group had nosignificant difference (P>0.05). The onset time was mainly in the spring andsummer for both groups.3. The degree of fever between the study group and the control grouphad no significant difference (P>0.05). Two groups were mainly with highdegree fever. In the study group, the rash appeared on the day ofdefervescence or one day later.4. In the study group, the duration of fever among all age groups andgender groups had no significant difference (P>0.05). The durationbetween the study group and the control group had no significant difference(P>0.05), the average duration was3.05days within the study group and was3.25days within the control group.5. The initial time: from the onset of fever to the beginning of decreasein white-blood-cell count (“WBC”) and absolute neutrophil count (“ANC”).The duration: from the discovery of decrease in WBC and ANC to thetime when WBC and ANC reach the minimum level.The initial time of the study group was1.27days which wassignificantly shorter than2.35days in the control group (P<0.05). Theduration between study group and control group had no significantdifference (P>0.05). The duration was within0-2days for both groups.6. There was no significant difference in WBC and ANC level betweenthe study group and the control group (P>0.05). 7. The WBC recovery time within the study group was3.05days whichwas significantly shorter than3.65days within the control group. On thedischarge day, the ANC level still didn’t reach normal value (the averagedays in hospital was4.8days), however it was significantly higher than thelevel on the admission day. In the control group, the average recovery time ofANC was4.40days. The ANC recovery time was longer than the WBCrecovery time in both study group and control group.8. In the study group, there was no significant difference in recoverytime of WBC between patients using leucocyte-stimulating treatment andnot (P>0.05) and meantime no significant difference was observed in therecovery time of WBC among different leucocyte-stimulating treatmentprograms (P>0.05).Conclusions:Exanthem subitum with neutropenia was more common in boys under3years old. It usually attacked the children in summer together with high fever,and the rash appeared on the day of defervescence or one day later. The levelof WBC and ANC reduced after one to two days with fever. There was nosignificant difference in recovery time of WBC between patients usingleucocyte-stimulating treatment and not. The ANC recovery time was longerthan WBC recovery time. The WBC recovery time of the study group wasshorter than the time of the control group, which suggested that Exanthemsubitum with neutropenia had a better prognosis.