Hsia Shao-Hsuan, Lin Jainn-Jim, Wu Chang-Teng, Huang I-Anne, Lin Kuang-Lin
Divisions of Pediatric Critical Care and Emergency Medicine,Chang Gung Children's Hospital and Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taoyuan 333, Taiwan.
Am J Emerg Med. 2010 Jul;28(6):749.e1-3. doi: 10.1016/j.ajem.2009.10.015. Epub 2010 Mar 25.
Stridor is a commonly encountered presenting symptom of upper airway obstruction in the pediatric population. Although infection etiologies such as croup, retropharyngeal abscess, and epiglottitis predominate in the pediatric population, other less common etiologies must also be considered in the differential diagnosis. We report a case of 3-year-2-month-old girl who exhibited the following symptoms: progressive hoarseness, backing cough, and dyspnea. Initial clinical symptoms were mimicking croup. After admission, she developed progressive muscle weakness and areflexia. Flexible laryngoscopy showed bilateral vocal cord paralysis. Finally, she was diagnosed with Guillain-Barré syndrome (GBS). We emphasized that the early recognition of atypical presentations of GBS warrants further evaluation and appropriate management.
喘鸣是儿科人群上呼吸道梗阻常见的就诊症状。虽然诸如哮吼、咽后脓肿和会厌炎等感染性病因在儿科人群中占主导，但在鉴别诊断中也必须考虑其他不太常见的病因。我们报告一例3岁2个月大的女孩，她出现了以下症状：进行性声音嘶哑、犬吠样咳嗽和呼吸困难。最初的临床症状类似哮吼。入院后，她出现了进行性肌无力和反射消失。纤维喉镜检查显示双侧声带麻痹。最终，她被诊断为吉兰-巴雷综合征（GBS）。我们强调，早期识别GBS的非典型表现需要进一步评估和适当处理。
