5 days ago, my sister’s 2-month-old grandson due to cough fever in the local hospital treatment, after the improvement of home there is a high fever, sweating, poor spirit, rushed to Wuhan Children’s Hospital, a blood test suggests that the liver is damaged, heart damage, lung infections, and ask for a history of the original sister’s grandson’s wife for fear of the child catching a cold to the child wrapped up very tightly, and sometimes cover the mouth and nose, and at night, two hot water bags on either side of the wrapped quilt. The hospital considered masked syndrome, also known as muffled fever syndrome, admitted to the intensive care unit, regret, can only silently pray that the little grandson can get better every day. The syndrome is due to excessive warmth or cover too long and a series of high fever, dehydration, hypoxia followed by coma, respiratory and circulatory failure as the manifestation of a group of syndromes, more often occurring in the cold season, most common in rural areas and infants less than 1 year old, especially within 6 months and newborns are more common. The pathogenesis of this disease is mainly due to the increase in environmental temperature, which puts the body in a high fever state, and the skin evaporates and sweats to accelerate heat dissipation, and excessive water loss results in hypertonic dehydration, causing a decrease in the effective circulating blood volume and microcirculatory disorders, and finally resulting in shock. At the same time, high fever makes the body metabolism hyperoxia increased oxygen consumption, coupled with the lack of fresh air in the quilt leads to hypoxia, acidosis, and then affect the heart, lungs, brain, liver, kidneys and other multi-organ function. It may even affect the development of the nervous system, leaving sequelae such as epilepsy and mental retardation, and the mortality rate is extremely high. The clinical characteristics of masked syndrome: ① seasonal: November to March of the following year for the onset of the season; ② age: 6 months of small infants and newborns are common, because small infants and newborns are unable to break free of tightly masked clothing; ③ there are often thick clothing wrapped, masked triggers; ④ for the sudden onset of the night, the general condition of the general condition of the disease before the disease, and occasionally have a sense of diarrhea or history of diarrhea; ⑤ are sweating, dehydration, hypoxia, even Convulsions, apnea, coma; (6) severe cases of multi-organ failure, lungs, brain, heart, kidneys, stomach, intestines are the most vulnerable; (7) blood biochemistry is often changed; (8) long-term prognosis is not optimistic. Diagnosis and treatment: masked syndrome Diagnosis is not difficult, but because it occurs in the cold winter, and after the onset of most have high fever, hypoxia, respiratory failure performance, easy to misdiagnose as a cold, pneumonia and delayed diagnosis and treatment, according to the clinical features of this disease: for winter, nighttime onset of the disease, before the onset of the general condition is good, there is a clear history of masking or over-warming, the emergence of sweating, hyperthermia, dehydration, hypoxia, the clinical signs, can be diagnosed. . Abnormal increase of cardiac enzyme spectrum and renal function abnormality are important diagnostic bases for masked syndrome. The treatment of this disease should firstly remove the cause of heat covering immediately and get out of the stuffy environment as soon as possible. Physical cooling, rapid administration of oxygen, rehydration, acid correction, anti-shock, stopping shock, lowering intracranial pressure, nutrition of myocardium, liver protection, stimulation of respiration and promotion of cerebral recovery should be given. When montee syndrome occurs due to the stress reaction caused by hyperglycemia and high osmolality, hypertonic fluids should be avoided as much as possible, and 5% dextrose should be used as much as possible so as not to aggravate the condition by further elevation of blood glucose. As for electrolyte disorders such as hyponatremia, they should be supplemented or corrected slowly according to the laboratory results, and should not be rushed. Preventive measures: more to the rural families to make science knowledge propaganda, develop good sleeping habits, the implementation of mother and child sleep, sleep, do not wrap too much too tight or cover the mouth and nose, maintain indoor ventilation, more eyes at night to see the child a few times, can help to reduce the occurrence of the disease.