脑型疟疾后出现严重喘鸣和严重无力。
Severe stridor and profound weakness after cerebral malaria.
机构信息
Department of Paediatrics, Leeds General Infirmary, Leeds, UK.
Oxford Vaccine Group, University of Oxford, Oxford, UK
出版信息
BMJ Case Rep. 2021 Apr 13;14(4):e237681. doi: 10.1136/bcr-2020-237681.
Cerebral malaria (CM) is defined by WHO as coma (Blantyre Coma Score 2 or less) in a patient with parasitaemia and no alternative cause of coma identified. Mortality is approximately 15%-30% in African children and up to one-third of survivors have neurological sequelae. We present a patient with severe stridor and prolonged profound weakness during an intensive care admission with CM. These complications initially presented a diagnostic dilemma in our limited resourced setting. The stridor failed to improve with empiric steroids and a subsequent opportunistic ENT consult diagnosed vocal cord paresis. The weakness was so profound that the patient was unable to lift his head during the acute illness. The child received intensive physiotherapy, and at 1-month follow-up, the stridor and weakness had resolved.
脑型疟疾（CM）被世界卫生组织定义为寄生虫血症患者出现昏迷（Blantyre 昏迷评分 2 或更低），且无其他原因导致昏迷。在非洲儿童中，死亡率约为 15%-30%，三分之一的幸存者有神经后遗症。我们报告了一例 CM 患者在重症监护病房入院期间出现严重的喘鸣和长时间的深度无力。这些并发症在我们资源有限的环境中最初构成了诊断难题。喘鸣并未因经验性类固醇治疗而改善，随后的机会性耳鼻喉科咨询诊断为声带无力。患者的无力非常严重，以至于在急性疾病期间无法抬起头。该患儿接受了强化物理治疗，在 1 个月的随访中，喘鸣和无力已经缓解。
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