Zhang Yv, Wang Sheng-Yuan, Guo Da-Zhi, Pan Shu-Yi, Lv Yan
Department of Hyperbaric Oxygen, The Sixth Medical Center of PLA General Hospital, Beijing 100048, China.
World J Clin Cases. 2021 May 16;9(14):3327-3333. doi: 10.12998/wjcc.v9.i14.3327.
Acute flaccid paralysis (AFP) and neurogenic respiratory failure rarely occur in children. At the end of 2018, some children with such symptoms were admitted to our hospital. In this study, we aimed to assess two children with AFP and neurogenic respiratory failure associated with enterovirus D68 (EV-D68).
Two children admitted to our hospital presented with symptoms and imaging results different from those of acute disseminated encephalomyelitis and hand, foot, and mouth disease. Their main symptoms were AFP and neurogenic respiratory failure. Magnetic resonance imaging showed severe inflammatory injury mainly to the anterior horn cells of the spinal cord. Blood and cerebrospinal fluid samples were collected to assess for pathogens, including bacteria, tuberculosis, cryptococcus, herpes virus, and coxsackie virus, and the results were negative. At the beginning, the two cases were not assessed for EV-D68 in the nasopharyngeal, blood, and cerebrospinal fluid specimens. About 2 mo later, EV-D68 was detected in the stool sample of one of the cases. The symptom of AFP was caused by injury to the anterior horn cells at levels C5-L5 of the spinal cord, while neurogenic respiratory failure was at levels C3-C5.
We should pay attention to the detection and diagnosis of EV-D68 and make efforts to develop antivirus drugs and vaccines.
急性弛缓性麻痹（AFP）和神经源性呼吸衰竭在儿童中很少发生。2018年底，我院收治了一些出现此类症状的儿童。在本研究中，我们旨在评估两名患有与肠道病毒D68（EV-D68）相关的AFP和神经源性呼吸衰竭的儿童。
我院收治的两名儿童表现出与急性播散性脑脊髓炎和手足口病不同的症状及影像学结果。他们的主要症状为AFP和神经源性呼吸衰竭。磁共振成像显示主要是脊髓前角细胞受到严重炎性损伤。采集血液和脑脊液样本以评估病原体，包括细菌、结核、隐球菌、疱疹病毒和柯萨奇病毒，结果均为阴性。起初，这两例病例未对鼻咽、血液和脑脊液标本进行EV-D68检测。约2个月后，在其中1例病例的粪便样本中检测到EV-D68。AFP症状是由脊髓C5-L5节段的前角细胞损伤引起的，而神经源性呼吸衰竭是由C3-C5节段损伤所致。
我们应重视EV-D68的检测与诊断，并努力研发抗病毒药物和疫苗。
