小儿肺炎是儿科常见病,多发病,诊断比较容易。但某些疾病由于症状不够典型并伴有呼吸困难时,往往容易误诊为肺炎,现举例讨论之。例1:男,6个月。缘发烧伴呼吸困难1天住院。查体:可见口周紫绀及鼻翼扇动。前囟不凸出,颈软。两肺未闻湿罗音,心率140次/分。肝肋下2cm。诊为“支气管肺炎并心力衰竭”。次日发现患儿频繁抽搐,很快昏迷。腰穿结果为黄色粘稠脓性脑脊液,确诊为化脓性脑膜炎。经多方抢救无效死亡。例2:男,10个月。因发烧9小时,阵阵喘憋收住院。查体:精神萎靡,气促,呼吸伴呻吟,口周紫绀。两肺可闻痰鸣,未闻及罗音,心率180次/分,腹胀气,肝肋下2.5cm。诊为“支气管肺炎并心力衰竭”。入院后发现患儿不时小抽动,灌肠 Pediatric pneumonia is a common pediatric disease, frequently-occurring disease, the diagnosis is relatively easy. However, some diseases are often easily misdiagnosed as pneumonia due to the symptoms are not typical and accompanied by breathing difficulties, are discussed in the following examples. Example 1: Male, 6 months. Fever with fever 1 day hospitalization. Physical examination: visible perioral cyanosis and nose flap. Anterior fontanel not protruding, neck soft. Two lungs did not hear wet rales, heart rate 140 beats / min. Liver ribs 2cm. Diagnosis as “bronchial pneumonia and heart failure.” The next day found that children with frequent convulsions, and soon coma. Waist wear results yellow sticky purulent cerebrospinal fluid, diagnosed with purulent meningitis. Rescued by multiple invalid death. Example 2: Male, 10 months. 9 hours due to fever, bursts of breath admitted to hospital. Physical examination: apathetic, shortness of breath, moaning with breathing, perioral cyanosis. Phlegm can be heard in both lungs, no smell and rales, heart rate 180 beats / min, abdominal distension, liver ribs 2.5cm. Diagnosis as “bronchial pneumonia and heart failure.” After admission found that children from time to time twitch, enema