Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, AM, 69040-000 Brazil.
Programa de Pós-graduação em Ciências da Saúde, Faculdade de Medicina, Universidade Federal do Amazonas, Manaus, AM, 69080-900 Brazil.
J Trop Pediatr. 2021 Jul 2;67(3). doi: 10.1093/tropej/fmaa044.
We report the case of a 15-year-old male patient presenting frontal headaches with retro-orbital pain accompanied by fever evolving to weakness and pain of the lower limbs, which ascended to upper limbs. A COVID-19 rapid test (IgG and IgM) and nasopharyngeal swab polymerase chain reaction (PCR) was positive for SARS-CoV-2. The blood tests, cerebral spinal fluid (CSF) analysis and CSF aerobic culture revealed no abnormalities. PCR testing of the CSF was negative for the most prevalent etiologies as well as for SARS-CoV-2. Electroneurography study was compatible with the acute motor axonal neuropathy variant of Guillain-Barré syndrome. No cases involving young patients have been presented to date. Therefore, this is the first reported pediatric case of SARS-CoV-2 infection associated with GBS. Evidence reveals that SARS-CoV-2 infection is not limited to the respiratory tract. Neurotropism could explain this important neurologic manifestation of COVID-19 in children.
我们报告了一例 15 岁男性患者，其表现为伴有眶后疼痛的额部头痛，伴有发热，继而出现下肢无力和疼痛，并向上肢蔓延。COVID-19 快速检测（IgG 和 IgM）和鼻咽拭子聚合酶链反应（PCR）均对 SARS-CoV-2 呈阳性。血液检查、脑脊液（CSF）分析和 CSF 需氧培养均未见异常。CSF 的 PCR 检测对最常见的病因以及 SARS-CoV-2 均为阴性。电神经图研究符合吉兰-巴雷综合征的急性运动轴索性神经病变异型。迄今为止，尚未报告涉及年轻患者的病例。因此，这是首例报告的 SARS-CoV-2 感染相关吉兰-巴雷综合征的儿科病例。证据表明，SARS-CoV-2 感染不仅限于呼吸道。神经嗜性可以解释 COVID-19 在儿童中的这一重要神经表现。
