From the Division of Pediatric Cardiology.
Division of Pediatric Infectious Disease.
Pediatr Infect Dis J. 2020 Dec;39(12):e445-e447. doi: 10.1097/INF.0000000000002939.
We report a case of a 15-year-old female presenting with a serious multisystemic inflammatory illness during a surge of SARS-CoV-2 (COVID-19) cases in our county. The initial clinical findings of sore throat and neck stiffness, followed by signs of sepsis, raised suspicion of Lemierre syndrome early in her hospital course. However, the presence of severe respiratory distress, multifocal pneumonia with pleural effusion on chest radiograph, acute kidney injury, and the discovery of coronary artery ectasia, pointed to the new entity "multisystem inflammatory syndrome in children (MIS-C)." Immune modulatory treatment was thus considered. However, progressive neck pain and swelling, coupled with the eventual growth of Fusobacterium necrophorum on blood culture, eventually led to the correct diagnosis of Lemierre syndrome.
我们报告了一例 15 岁女性病例，在我县 SARS-CoV-2（COVID-19）病例激增期间，出现严重的多系统炎症性疾病。她在医院就诊初期，出现咽痛和颈部僵硬的初始临床发现，随后出现脓毒症迹象，这使得人们早期怀疑莱姆病综合征。然而，严重呼吸窘迫、胸片显示多发性肺炎伴胸腔积液、急性肾损伤以及冠状动脉扩张的发现，指向了新的实体“儿童多系统炎症综合征（MIS-C）”。因此，考虑使用免疫调节治疗。然而，进行性颈部疼痛和肿胀，加上最终血液培养中发现坏死梭杆菌，最终导致了莱姆病综合征的正确诊断。
