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首页> 外文期刊>Medicine, science, and the law >Retinal haemorrhages associated with fatal paediatric infections
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Retinal haemorrhages associated with fatal paediatric infections

机译：与致命的小儿感染有关的视网膜出血

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摘要

For many physicians, retinal haemorrhages (RHs) in infants and young children remain highly diagnostic of non-accidental (abusive) head trauma. Because clinicians have applied indirect ophthalmoscopy selectively to cases of suspected child abuse, the association between RH and other conditions such as infection, coagulopathy and accidental trauma has encountered habitual bias, creating the potential for iatrogenic misdiagnosis of child abuse. We present an autopsy case series of four children, aged three years old or younger, in whom RHs were detected by post-mortem monocular indirect ophthalmoscopy after the patients had died from infections. We discuss the laterality, number, type and location of RHs in these cases, and summarize proposed mechanisms of RH formation in fatalities from paediatric infection. We demonstrate that many of the ophthalmological findings that have been considered diagnostic of abusive head trauma can also occur in association with infective processes.
机译：对于许多医生而言，婴儿和幼儿的视网膜出血（RHs）仍然可以高度诊断出非偶然性（虐待性）头部外伤。由于临床医生选择性地将间接检眼镜应用于疑似虐待儿童的病例，因此RH与其他状况（如感染，凝血病和意外创伤）之间的关联会出现习惯偏见，从而可能导致医源性误诊虐待儿童。我们提供了一个尸检病例系列，其中有四名三岁或三岁以下的儿童，在这些患者死于感染后，通过验后单眼间接检眼镜检查发现了RH。我们讨论了在这些情况下RH的偏侧性，数量，类型和位置，并总结了在小儿感染致死中的RH形成机制。我们证明，许多眼科研究结果也被认为可诊断出虐待性头部创伤，也可能与感染过程有关。

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