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一名患有重症新型冠状病毒肺炎的儿童出现纵隔气肿。

Pneumomediastinum in a child with severe COVID-19.

作者信息

Carroll Anne G, Quinn Nuala, Byrne Carl, Kassab Ghadir, Whelan Siobhan, Colleran Gabrielle C

机构信息

Department of Radiology, Children's Health Ireland at Temple Street, Dublin, Ireland.

Emergency Department Research Group, Murdoch Children's Research Institute, Melbourne, Australia.

出版信息

BJR Case Rep. 2020 Nov 26;7(1):20200062. doi: 10.1259/bjrcr.20200062. eCollection 2021 Feb 1.


DOI:10.1259/bjrcr.20200062
PMID:33614114
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7869130/
Abstract

The current global pandemic of the novel coronavirus SARS-CoV2 is a threat to the health and lives of millions of people worldwide. The latest statistics from the World Health Organisation show that there have been 6,515,796 confirmed cases worldwide with 387,298 confirmed deaths (last update 5 June 2020, 10:41 CEST). The majority of critically unwell patients with SARS-CoV2 are adults and the radiological findings associated with them are consistent throughout the literature. However, the reported paediatric cases are few, and as such, there is a limited body of evidence available. More international data is needed, not only on the clinical presentation, but also the radiological findings, so that health-care providers are better able to understand and diagnose this pandemic disease. We describe a case of a previously healthy 9-year-old female who presented to the Emergency Department with symptoms suggestive of raised intracranial pressure. Her CT revealed a medulloblastoma and post-operatively she tested positive for SARS-CoV2. She had a rapid deterioration in her clinical condition and required admission to the intensive care unit (ICU). We provide the supporting radiology along her clinical course in order to demonstrate important insights into this disease in children, including the unusual pnemomediastinum complications which occurred as part of her clinical course. This case is the first reported of its kind.

摘要

当前新型冠状病毒SARS-CoV2在全球范围内的大流行对全世界数百万人的健康和生命构成威胁。世界卫生组织的最新统计数据显示,全球已有6515796例确诊病例,387298例确诊死亡(最后更新时间为2020年6月5日,欧洲中部夏令时间10:41)。大多数感染SARS-CoV2的重症患者为成年人,相关文献中关于他们的影像学表现较为一致。然而,报告的儿科病例较少,因此可用的证据有限。不仅需要更多关于临床表现的国际数据,还需要更多关于影像学表现的数据,以便医疗保健提供者能够更好地理解和诊断这种大流行疾病。我们描述了一例9岁健康女性病例,她因疑似颅内压升高的症状就诊于急诊科。她的CT显示为髓母细胞瘤,术后SARS-CoV2检测呈阳性。她的临床状况迅速恶化,需要入住重症监护病房(ICU)。我们提供了她整个临床过程中的相关影像学资料,以展示对儿童这种疾病的重要见解,包括作为其临床过程一部分出现的不寻常的纵隔气肿并发症。该病例是首例此类报告。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9c50/7869130/26de58126d30/bjrcr.20200062.g008.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9c50/7869130/f55fca1ec99e/bjrcr.20200062.g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9c50/7869130/4466c6c841a4/bjrcr.20200062.g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9c50/7869130/b7dd3a8582fe/bjrcr.20200062.g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9c50/7869130/9b9a6f9c1351/bjrcr.20200062.g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9c50/7869130/411ff28efed2/bjrcr.20200062.g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9c50/7869130/106bd60c0559/bjrcr.20200062.g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9c50/7869130/7582e2362b32/bjrcr.20200062.g007.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9c50/7869130/26de58126d30/bjrcr.20200062.g008.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9c50/7869130/f55fca1ec99e/bjrcr.20200062.g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9c50/7869130/4466c6c841a4/bjrcr.20200062.g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9c50/7869130/b7dd3a8582fe/bjrcr.20200062.g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9c50/7869130/9b9a6f9c1351/bjrcr.20200062.g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9c50/7869130/411ff28efed2/bjrcr.20200062.g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9c50/7869130/106bd60c0559/bjrcr.20200062.g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9c50/7869130/7582e2362b32/bjrcr.20200062.g007.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9c50/7869130/26de58126d30/bjrcr.20200062.g008.jpg

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引用本文的文献

[1]
Spontaneous Pneumomediastinum in a 16-Year-Old Patient with SARS-CoV-2 Infection: A North-East Romanian Case.

Children (Basel). 2022-10-27

[2]
COVID-19 presenting with spontaneous massive pneumomediastinum in a three-month-old child.

Anaesth Rep. 2021-7-22

本文引用的文献

[1]
Differences in Clinical and Imaging Presentation of Pediatric Patients with COVID-19 in Comparison with Adults.

Radiol Cardiothorac Imaging. 2020-4-6

[2]
Coronavirus Disease 2019 in the Perioperative Period of Lung Resection: A Brief Report From a Single Thoracic Surgery Department in Wuhan, People's Republic of China.

J Thorac Oncol. 2020-4-11

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J Public Health Manag Pract. 2020

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Clinical Characteristics of COVID-19 After Gynecologic Oncology Surgery in Three Women: A Retrospective Review of Medical Records.

Oncologist. 2020-4-7

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Clin Exp Pediatr. 2020-4

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