Karn Michele N, Johnson Nicholas P, Yaeger Susan K, Fugok Kimberly L
Department of Emergency and Hospital Medicine/University of South Florida, Morsani College of Medicine Lehigh Valley Health Network Allentown Pennsylvania USA.
Lehigh Valley Health Network, Department of Emergency and Hospital Medicine Division of Pediatric Emergency Medicine/University of South Florida, Morsani College of Medicine Allentown Pennsylvania USA.
J Am Coll Emerg Physicians Open. 2020 Sep 26;1(6):1392-1394. doi: 10.1002/emp2.12261. eCollection 2020 Dec.
Symptoms of coronavirus disease 2019 overlap with other important illnesses affecting young adults. We report a case of a 17-year old male presenting to the emergency department in the midst of a pandemic with symptoms of coronavirus disease 2019. He had fever, dyspnea, chest pain, and myalgias, with bilateral infiltrates on chest radiograph, and developed septic shock secondary to infectious thromboembolic events. However, his blood cultures grew group G streptococcus secondary to his oropharyngeal infection, and he experienced an infectious thrombus in the internal jugular vein, consistent with the rare but well-described Lemierre's syndrome. This case report calls attention to the importance of maintaining differential diagnoses and thereby minimizing the biases and assumptions that come with clinical care during a pandemic.
2019冠状病毒病的症状与影响年轻人的其他重要疾病重叠。我们报告一例17岁男性病例，在大流行期间因出现2019冠状病毒病症状而到急诊科就诊。他有发热、呼吸困难、胸痛和肌痛，胸部X线片显示双侧浸润，并因感染性血栓栓塞事件继发感染性休克。然而，他的血培养结果显示为口咽感染继发的G组链球菌，并且他在内颈静脉出现了感染性血栓，符合罕见但有充分描述的勒米尔综合征。本病例报告提醒人们注意保持鉴别诊断的重要性，从而尽量减少大流行期间临床护理中出现的偏差和假设。
