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儿童莱姆神经Borreliosis 以腹痛为首发表现:病例报告及文献复习。

Abdominal pain as first manifestation of lyme neuroborreliosis in children, case report and review of literature.

机构信息

Pediatric Clinic, Maggiore Hospital, ASST Crema, Crema, Italy.

Department of Pediatrics, Foundation IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy.

出版信息

Ital J Pediatr. 2020 Nov 23;46(1):172. doi: 10.1186/s13052-020-00936-y.

Abstract

BACKGROUND

Lyme neuroborreliosis can cause a variety of neurological manifestations. European children usually present facial nerve palsy, other cranial nerve palsies and aseptic meningitis.

CASE PRESENTATION

We hereby report a case of Lyme neuroborreliosis in a 9-year-old boy with abdominal pain as first symptom and subsequent onset of attention deficit and ataxia. Diagnosis was made by detection of specific antibody in both serum and cerebrospinal fluid with neuro-radiological images suggestive for this infectious disease. A 12-months follow-up was performed during which no relevant neurological sequelae were revealed.

CONCLUSION

This case report shows that abdominal radiculitis, although extremely rare, could be the first manifestation of early Lyme neuroborreliosis in pediatric patients. Pediatricians must consider Lyme disease in the differential diagnosis of abdominal pain of unknown origin in children, especially in countries where the infection is endemic.

摘要

背景

莱姆神经Borreliosis 可引起多种神经系统表现。欧洲儿童通常表现为面神经麻痹、其他颅神经麻痹和无菌性脑膜炎。

病例介绍

我们在此报告一例莱姆神经Borreliosis 病例,为 9 岁男孩,以腹痛为首发症状,随后出现注意力缺陷和共济失调。通过血清和脑脊液中特异性抗体的检测,神经影像学图像提示该传染病的诊断。进行了 12 个月的随访,未发现相关的神经后遗症。

结论

本病例报告表明,腹神经根炎虽然极为罕见,但可能是儿科患者早期莱姆神经Borreliosis 的首发表现。儿科医生在对儿童不明原因腹痛进行鉴别诊断时,必须考虑莱姆病,尤其是在感染流行的国家。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9faa/7684897/a2b65113932c/13052_2020_936_Fig1_HTML.jpg

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