Kirill Micallef-Stafrace, Danica Bonello Spiteri, Al Shehhi Mouza, Galea Dermot
Institute for Physical Education and Sport, University of Malta, Malta.
Asian J Sports Med. 2010 Dec;1(4):223-7. doi: 10.5812/asjsm.34836.
Athletes present a different category of the population. Trivial complaints may mask more serious illness, especially when the athlete is undergoing intensive training, and the function of his immune system may be sub-optimal.
A triathlete presented a few days after completing an Ironman race, complaining of lethargy, pleuritic chest pain and loss of appetite. On examination he was afebrile, tachycardic and had decreased lower left lung air entry accompanied by crackling. A chest x-ray revealed left-sided basal pneumonia with a para-pneumonic effusion. Blood tests were unremarkable. The athlete was treated with oral antibiotics, and was advised to stop exercise completely for eight weeks. He made a full recovery and completed further Ironman races within a year.
The case highlights that clinicians treating elite endurance athletes must exclude severe infection, even when the clinical signs are few or absent. The reason is that if these athletes continue to train, serious complications could ensue due to their compromised resistance to infection.
运动员是一类特殊人群。一些轻微的不适可能掩盖更严重的疾病,尤其是当运动员正在进行高强度训练且其免疫系统功能可能并非最佳时。
一名铁人三项运动员在完成铁人三项比赛几天后前来就诊,主诉乏力、胸膜炎性胸痛和食欲不振。检查时,他体温正常,心动过速,左下肺呼吸音减弱并伴有湿啰音。胸部X光显示左侧基底肺炎伴胸腔积液。血液检查无异常。该运动员接受了口服抗生素治疗,并被建议完全停止运动八周。他完全康复,并在一年内完成了更多的铁人三项比赛。
该病例强调,治疗精英耐力运动员的临床医生必须排除严重感染,即使临床症状很少或没有。原因是如果这些运动员继续训练,由于他们对感染的抵抗力受损,可能会引发严重并发症。