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勿忘流感——确定一名儿童感染性肌炎的病因:病例报告

Don't Forget the Flu - Determining the Etiology of Infective Myositis in a Child: A Case Report.

作者信息

Crowley Lauren M, Mazzaccaro Richard J, Dunn Amy Lewis, Bauch Sarah E, Greenberg Marna Rayl

机构信息

University of South Florida Morsani College of Medicine, Lehigh Valley Campus, Lehigh Valley Health Network, Department of Emergency and Hospital Medicine, Allentown, Pennsylvania.

University of South Florida Morsani College of Medicine, Lehigh Valley Campus, Lehigh Valley Health Network, Department of Pediatrics, Allentown, Pennsylvania.

出版信息

Clin Pract Cases Emerg Med. 2021 Feb;5(1):105-108. doi: 10.5811/cpcem.2020.12.50405.

Abstract

INTRODUCTION

Infective myositis is an acute, self-limited condition, rarely occurring in children with recent viral infections. The condition is often overlooked by emergency physicians when endeavoring to exclude other diagnoses included in the differential. Diagnosis of the condition can be difficult when based purely on clinical presentation because it shares symptoms with much more concerning neurological illnesses. A few simple laboratory tests are indicated to reach the correct diagnosis.

CASE REPORT

The following case report describes a three-year-old female diagnosed with a recent upper respiratory tract infection presenting to the emergency department with complaints of fatigue and inability to walk. She was diagnosed with an influenza-like illness three days prior by her pediatrician, the symptoms of which had mostly resolved by the time of presentation.

CONCLUSION

Muscle weakness and abnormal, uncoordinated gait with an acute upper respiratory tract infection in a child may be cause for concern, prompting unnecessary work-up. Emergency physicians should be aware of the signs and symptoms of influenza-associated infective myositis in children, especially during influenza season.

摘要

引言

感染性肌炎是一种急性自限性疾病,在近期有病毒感染的儿童中很少发生。当急诊科医生努力排除鉴别诊断中的其他疾病时,这种疾病常常被忽视。单纯基于临床表现来诊断这种疾病可能很困难,因为它与更令人担忧的神经系统疾病有共同症状。需要进行一些简单的实验室检查以做出正确诊断。

病例报告

以下病例报告描述了一名三岁女性,近期被诊断为上呼吸道感染,因疲劳和无法行走而到急诊科就诊。三天前她的儿科医生诊断她患有流感样疾病,到就诊时其症状大多已缓解。

结论

儿童出现肌肉无力以及伴有急性上呼吸道感染的异常、不协调步态可能令人担忧,从而引发不必要的检查。急诊科医生应了解儿童流感相关感染性肌炎的体征和症状,尤其是在流感季节。

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