4.下列诊断除哪几点外均有可能
4.
All of the following diagnoses are possible except
5.小儿头颅拍片显示颅内广泛钙化。
5.
The child's skull x-ray shows diffuse intracranial calcifications.
总IgM为60mg% (60mg/L)，以下哪些实验应该进行
And the total lgM is 60 mg%.
Which of the following tests should be obtained?
C.母亲和婴儿作弓形体间接荧光抗体（IFA）
C.
IFA (indirect fluorescent antibody) for toxoplasmosis (mother and infant)
D.母亲和婴儿IgM抗弓形体抗体
D. lgM against toxoplasmosis antibody (mother and infant)
6.除母亲及婴儿弓形体间接荧光抗体均大于1／5000外，所有以上试验均为阴性。
6.
All of the above tests are negative except for the toxoplasmosis IFA which is greater than 1/5000 in the mother and infant.
治疗应给
Therapy should be
男性婴儿，胎龄约36周，母23岁。
A male infant is born after approximately 36 weeks gestation to a 23-year-old mother.
出生时小儿体重l700g。
The infant weighs 1700 g at birth.
这是母亲第一次怀孕。
This is the mother's first pregnancy.
婴儿体征正常。
The infant has normal vital signs.
身长、体重及头围均低于同胎龄的第10百分位数。
Length, weight, and head circumference are all below the tenth percentile for gestational age.
小儿肝脾均肿大，各在肋缘下5.0cm，无淋巴结肿大或皮疹。
The child has a massively enlarged spleen and liver, each 5 cm below the costal margins.
There is no adenopathy or skin rash.
白细胞计数及血红蛋白均正常。
The total white count and hemoglobin are normal.
血小板计数约16 500／mm3(16.5×109／L)。
The platelet concentration is approximately 16,500 platelets/ mm3.
天门冬氨酸氨基转移酶及氨基亮氨酸转移酶均为490JU/ml，生后第一天胆红素为4mg％(68.4umol／L)，直接胆红素为4mg％(68.4umol／L)。
AST and ALT are 490 IU/ml, and the bilirubin on day 1 was 4 mg% with a direct bilirubin of 4 mg%.
B．颅骨X线拍片或头颅CT扫描
B.
Skull x-rays or CT scan of the head
这是由低于胎龄的出生体重，肝及脾肿大，血小板减少，肝酶增高及生后第一天出现直接胆红素增高而想到的。
This is suggested by the low birth weight for gestational age, the enlarged liver and spleen, thrombocytopenia, the elevated liver enzymes, and the elevated direct bilirubin occurring on the first day of life.
因此，为了诊断先天性风疹，先天性梅毒，先天性巨细胞病毒及先天性弓形体病应作适当的血清学试验。
Therefore, appropriate serological tests are indicated to diagnose congenital rubella, congenital syphilis, congenital cytomegalovirus, and congenital toxoplasmosis.
X纸片或CT扫描可以确定颅内钙化，这种情况可在先天性弓形体病或在先天性巨细胞病毒感染时出现。
An x-ray or CT scan would identify intracranial calcifications which may occur with either congenital toxoplasmosis or congenital cytomegalovirus infections.
应作仔细的眼底镜检查，所有以上感染均可出现视网膜脉络膜炎。
A careful funduscopic exam should be performed.Chorioretinitis can occur with all of the above infections.
腹部超声波有助于确定肝及脾肿大以及未触及的其他腹部包块。
An abdominal sonogram would be helpful to establish that the liver and spleen were enlarged and that other intraabdominal masses were not being palpated.
IgM测定是很重要的,因为母亲IgM不能通过胎盘，并且这种抗体是婴儿在妊娠最后数周自己产生的。
IgM is important because maternal IgM does not cross the placenta and this antibody is produced by the infant in the late weeks of pregnancy.
生后第l、2天总IgM正常值小于20mg％(200mg／L)。
The normal values for total IgM in the first day or two of life is less than 20 mg%.