Oliveira Gracinda Nogueira, Costa Sofia, Costa Filipa Dias, Dionísio Teresa, Carvalho Leonor
Department of Paediatrics, Hospital Pediátrico de Coimbra, Coimbra, Portugal.
Paediatric Intensive Care Unit, Hospital Pediátrico de Coimbra, Coimbra, Portugal.
BMJ Case Rep. 2018 Feb 8;2018:bcr-2017-223497. doi: 10.1136/bcr-2017-223497.
A 15-year-old boy was admitted to a local hospital with high fever, generalised rash and a mild sore throat. He was started on intravenous flucloxacillin and 12 hours later develops a sustained low diastolic blood pressure (DBP), unresponsive to fluid volume expansion and cardiovascular support with dopamine. Intravenous clindamycin was added and transportation to paediatric intensive care unit arranged. Dopamine dosing was increased and norepinephrine infusion was added subsequently with immediate stabilisation of DBP. A sacrococcygeal pilonidal abscess was identified, requiring prompt surgical drainage. The microbiological culture of abscess material was positive for an enterotoxin-producing He was free of symptoms after 4 days. This case report summarises a potential severe complication of the pilonidal disease.
一名15岁男孩因高热、全身性皮疹和轻度咽痛入住当地医院。他开始接受静脉注射氟氯西林治疗，12小时后出现持续性低舒张压（DBP），对液体量扩充和多巴胺的心血管支持无反应。加用静脉注射克林霉素，并安排转运至儿科重症监护病房。增加多巴胺剂量，随后加用去甲肾上腺素输注，DBP立即稳定。发现骶尾部藏毛窦脓肿，需要立即进行手术引流。脓肿材料的微生物培养显示产肠毒素的[具体细菌名称未给出]呈阳性。4天后他症状消失。本病例报告总结了藏毛疾病的一种潜在严重并发症。
