Department of Critical Care Medicine and the Safar Center for Resuscitation Research, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
Pediatr Crit Care Med. 2010 Mar;11(2):179-84. doi: 10.1097/PCC.0b013e3181cf4652.
To outline a series of cases demonstrating neurologic complications in children with Influenza infection. The ongoing 2009 influenza A (H1N1) presents significant challenges to the field of pediatric critical care and requires increased awareness of new presentations and sequelae of infection. Since World Health Organization declared a H1N1 pandemic, much attention has been focused on its respiratory manifestations of the illness, but limited information regarding neurologic complications has been reported.
Case series.
Pediatric intensive care unit of a tertiary care medical facility.
Four children admitted to the pediatric intensive care unit between March and November 2009 at the Children's Hospital of Pittsburgh with altered mental status and influenza infection.
None.
The clinical course was extracted by chart review and is summarized. All children demonstrated a coryzal prodrome, fever, and altered level of consciousness at admission, and one child presented with clinical seizures. Diagnostic studies performed to establish a diagnosis are summarized. All children had abnormal electroencephalograms early in their intensive care unit course and 50% had abnormal imaging studies. All children survived but 50% had neurologic deficits at hospital discharge.
We conclude that 2009 influenza A (H1N1) can cause significant acute and residual neurologic sequelae. Clinicians should consider Influenza within a comprehensive differential diagnosis in children with unexplained mental status changes during periods of pandemic influenza.
概述一系列病例，展示流感感染儿童的神经并发症。当前的 2009 年甲型 H1N1 流感对儿科重症监护领域提出了重大挑战，需要提高对新出现的临床表现和感染后遗症的认识。自世界卫生组织宣布 H1N1 大流行以来，人们对其疾病的呼吸道表现给予了极大关注，但有关神经并发症的信息有限。
病例系列。
匹兹堡儿童医院三级医疗设施的儿科重症监护病房。
2009 年 3 月至 11 月期间，有 4 名患有改变精神状态和流感感染的儿童入住匹兹堡儿童医院儿科重症监护病房。
无。
通过图表回顾提取临床过程并进行总结。所有患儿均表现出鼻咽炎前驱期、发热和入院时意识水平改变，1 例出现临床癫痫发作。总结了用于确诊的诊断性研究。所有患儿在重症监护病房早期均有异常脑电图，50%有异常影像学研究。所有患儿均存活，但 50%在出院时存在神经功能缺损。
我们得出结论，2009 年甲型 H1N1 流感可引起严重的急性和持续性神经后遗症。在大流行流感期间，对于出现不明原因精神状态改变的儿童，临床医生应将流感纳入全面鉴别诊断中。
