Pediatrics Department, Centro Hospitalar de Setubal EPE, Setubal, Portugal.
Pediatrics Department, Centro Hospitalar de Setubal EPE, Setubal, Portugal
BMJ Case Rep. 2021 Mar 18;14(3):e241099. doi: 10.1136/bcr-2020-241099.
The Epstein-Barr virus (EBV) is highly prevalent throughout the population. Although in most cases, the infection has a good prognosis, it can cause severe complications. We report a case of a healthy child with a primary EBV infection that evolved with two rare complications. She first presented in the emergency room with fever and sore throat, and was diagnosed with tonsillitis and medicated with antibiotic. She returned 7 days later for fatigue, vomiting and abdominal pain. The examination revealed tonsillitis, swollen cervical lymph nodes and pain in the right hypochondrium. An abdominal ultrasound was performed, compatible with acute acalculous cholecystitis. She was admitted in the paediatric nursery and medicated with intravenous antibiotics. The EBV serology revealed primary infection. Two days later, she developed cardiogenic shock and had to be transferred to an intensive care unit under mechanical ventilation and inotropics. She was discharged 12 days later, keeping a moderate left ventricular dysfunction.
人类疱疹病毒 4 型(EBV)在人群中广泛存在。虽然大多数情况下感染具有良好的预后,但它也可能导致严重的并发症。我们报告了一例健康儿童原发性 EBV 感染,并发两种罕见并发症。患儿因发热和咽痛首次就诊于急诊,被诊断为扁桃体炎,并接受抗生素治疗。7 天后因乏力、呕吐和腹痛再次就诊。检查发现扁桃体炎、颈淋巴结肿大和右上腹疼痛。行腹部超声检查提示急性非结石性胆囊炎。患儿收治于儿科病房,接受静脉抗生素治疗。EBV 血清学检查提示原发性感染。两天后,患儿出现心源性休克,需转入重症监护病房,行机械通气和正性肌力治疗。12 天后患儿出院,遗留中度左心室功能障碍。