[一名儿童的多发性游走性红斑、伯氏疏螺旋体淋巴细胞瘤和神经莱姆病]
[Multiple erythema migrans, Borrelia lymphocytoma and neuroborreliosis in a child].
作者信息
Schei Kasper, Modalsli Ellen H, Nag Torbjørn
机构信息
Barne- og ungdomsavdelinga, Helse Møre og Romsdal, Ålesund sjukehus, og, Fakultet for medisin og helsevitskap, NTNU.
Hudavdelinga, St. Olavs hospital, og, Institutt for klinisk og molekylær medisin, NTNU.
出版信息
Tidsskr Nor Laegeforen. 2023 Aug 3;143(11). doi: 10.4045/tidsskr.23.0159. Print 2023 Aug 15.
BACKGROUND
Lyme disease after a tick bite often presents as erythema migrans, yet less frequent variants of this disease, such as Borrelia lymphocytoma, multiple erythema migrans and neuroborreliosis, are also seen occasionally.
CASE PRESENTATION
We report a case of a tick-bitten child who first presented with an indistinct macular erythema around the left eye and a more distinct macular erythema on and around the left ear. The next day, she developed a facial palsy.
INTERPRETATION
The case was interpreted as facial multiple erythema migrans and Borrelia lymphocytoma on the ear, followed by neuroborreliosis. The diagnosis of lymphocytoma was made from clinical findings and PCR of skin biopsy. She recovered quickly after intravenous ceftriaxone and is now healthy.
背景
蜱虫叮咬后引发的莱姆病通常表现为游走性红斑，但这种疾病较少见的变体，如淋巴细胞瘤性伯氏疏螺旋体病、多发性游走性红斑和神经型伯氏疏螺旋体病，也偶尔可见。
病例介绍
我们报告一例蜱虫叮咬儿童病例，该患儿最初表现为左眼周围边界不清的斑疹性红斑以及左耳上及周围边界更清晰的斑疹性红斑。次日，她出现了面瘫。
解读
该病例被诊断为耳部面部多发性游走性红斑和淋巴细胞瘤性伯氏疏螺旋体病，随后发展为神经型伯氏疏螺旋体病。淋巴细胞瘤性伯氏疏螺旋体病的诊断依据临床症状及皮肤活检的聚合酶链反应结果。静脉注射头孢曲松后她恢复迅速，现已康复。
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