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发热与跛行:跳出框框思考。

Fever and limp: thinking outside the box.

作者信息

Mathison David J, Troy April, Levy Michael

机构信息

Division of Emergency Medicine, Children's National Medical Center, School of Medicine and Health Sciences, George Washington University, Washington, DC 20010, USA.

出版信息

Pediatr Emerg Care. 2012 Dec;28(12):1369-73. doi: 10.1097/PEC.0b013e318276c33b.

Abstract

Fever and limp is a common presentation in the pediatric emergency department. We describe a case of a 21-month-old female patient with prolonged fever and difficulty bearing weight, ultimately diagnosed with a large intracranial abscess. Intracranial abscesses are a rare cause of limp and an uncommon diagnosis in pediatric patients without underlying congenital heart disease. This case highlights the importance of differentiating the features of limp secondary to pain from limp secondary to weakness, which is particularly difficult in the preschool-aged group. It is imperative for practitioners to consider disease of the central nervous system when evaluating acutely nonambulatory children with fevers.

摘要

发热伴跛行是儿科急诊科的常见症状。我们描述了一例21个月大的女性患者,持续发热且负重困难,最终被诊断为巨大颅内脓肿。颅内脓肿是导致跛行的罕见原因,在没有潜在先天性心脏病的儿科患者中是一种不常见的诊断。该病例强调了区分疼痛继发跛行和无力继发跛行特征的重要性,这在学龄前儿童中尤其困难。对于评估急性不能行走且发热的儿童时,从业者务必考虑中枢神经系统疾病。

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