Chen I-Ju, Hu Su-Ching, Hung Kun-Long, Lo Chiao-Wei
Department of Pediatrics, Cathay General Hospital School of Medicine Department of Pediatrics, Fu-Jen Catholic University Hospital, New Taipei, Taiwan.
Medicine (Baltimore). 2018 Sep;97(36):e11831. doi: 10.1097/MD.0000000000011831.
We present the first case of enterovirus (EV) D68, lineage B3 infection, associated with acute flaccid myelitis (AFM) in Taiwan. AFM caused by EV D68 is relatively rare. This report highlights the importance of clinical recognition of the disease and discusses treatments that can benefit such patients.
A 5-year-old boy experienced sudden onset of acute flaccid paralysis (AFP) involving left arm after fever and respiratory symptoms for 3 days.
Magnetic resonance imaging (MRI) of the spinal cord revealed signal changes over segments C1 to T5 on a T2-weighted image (T2WI), compatible with the diagnosis of AFM. The EV D68 strain, cultured from the throat of the patient was identified.
We administered intravenous immunoglobulin (IVIG, 1g/kg, twice), pulse steroid therapy (methylprednisolone, 30 mg/kg, twice) and oral prednisolone (1mg/kg/day). Rehabilitation was also arranged.
The patient still had mild muscle atrophy over left arm after following-up for 1 year.
Early diagnosis and prompt management are essential for managing this kind of patient. IVIG, pulse therapy, and oral prednisolone may play crucial roles in controlling its clinical course.
我们报告台湾首例肠道病毒（EV）D68，B3 谱系感染，与急性弛缓性脊髓炎（AFM）相关。由 EV D68 引起的 AFM 相对罕见。本报告强调了对该疾病临床识别的重要性，并讨论了可使此类患者受益的治疗方法。
一名 5 岁男孩在发热和呼吸道症状 3 天后，突然出现累及左臂的急性弛缓性麻痹（AFP）。
脊髓磁共振成像（MRI）在 T2 加权图像（T2WI）上显示 C1 至 T5 节段有信号变化，符合 AFM 的诊断。从患者咽喉部培养出的 EV D68 毒株得到鉴定。
我们给予静脉注射免疫球蛋白（IVIG，1g/kg，两次）、脉冲类固醇疗法（甲泼尼龙，30mg/kg，两次）和口服泼尼松龙（1mg/kg/天）。还安排了康复治疗。
随访 1 年后，患者左臂仍有轻度肌肉萎缩。
早期诊断和及时处理对于这类患者的管理至关重要。IVIG、脉冲疗法和口服泼尼松龙可能在控制其临床病程中发挥关键作用。
