Kamali Aghdam Mojtaba, Shabani Mirzaee Hosein, Eftekhari Kambiz
Pediatric Department, Mousavi Hospital, Zanjan University of Medical Sciences, Zanjan, Iran.
Department of Pediatric, Bahrami Children's Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Case Rep Pulmonol. 2021 Mar 2;2021:8877182. doi: 10.1155/2021/8877182. eCollection 2021.
The manifestations of novel coronavirus are diverse and can manifest through respiratory, gastrointestinal, and even nervous symptoms. Respiratory involvement is usually an upper tract infection or pneumonia but can also present as other forms of pulmonary disorders. A 3-year-old boy presented with cough, hoarseness, and stridor. He was treated with dexamethasone and nebulized adrenaline and a clinical diagnosis of croup was established. After treatment, his symptoms improved for a short time, but suddenly cough exacerbated and was accompanied by respiratory failure and seizures. He was then intubated and mechanically ventilated. Because of the coronavirus epidemic, Reverse-Transcription Polymerase Chain Reaction (RT-PCR) assay was taken from the pharyngeal secretions and was positive. The child was isolated. Due to excessive respiratory secretions and worsening of the general condition, bronchoscopy was performed depicting an image compatible with bacterial tracheitis. He was treated with broad-spectrum antibiotics, antivirals, and supportive care. Finally, after 4 weeks of treatment, the child was discharged in good general condition. Croup is one of the respiratory symptoms of novel coronavirus and can be a risk factor for bacterial tracheitis. Therefore, the presence of clinical manifestations of croup indicates the need for coronavirus PCR testing.
新型冠状病毒的表现多种多样,可通过呼吸道、胃肠道甚至神经系统症状表现出来。呼吸道受累通常为上呼吸道感染或肺炎,但也可能表现为其他形式的肺部疾病。一名3岁男孩出现咳嗽、声音嘶哑和喘鸣。他接受了地塞米松和雾化肾上腺素治疗,并确诊为喉炎。治疗后,他的症状短期内有所改善,但突然咳嗽加剧,并伴有呼吸衰竭和癫痫发作。随后他被插管并进行机械通气。由于冠状病毒疫情,从咽部分泌物中进行了逆转录聚合酶链反应(RT-PCR)检测,结果呈阳性。该儿童被隔离。由于呼吸道分泌物过多且一般状况恶化,进行了支气管镜检查,显示出与细菌性气管炎相符的图像。他接受了广谱抗生素、抗病毒药物和支持治疗。最终,经过4周的治疗,该儿童康复出院,一般状况良好。喉炎是新型冠状病毒的呼吸道症状之一,可能是细菌性气管炎的危险因素。因此,出现喉炎的临床表现表明需要进行冠状病毒PCR检测。