Huzior Michael C, Chernicki Brendan P, Nguyen Lisa, Kumar Bobby
Pediatrics, Nova Southeastern University Dr. Kiran C. Patel College of Osteopathic Medicine, Davie, USA.
Pediatrics, Salah Foundation Children's Hospital at Broward Health Medical Center, Fort Lauderdale, USA.
Cureus. 2023 Dec 27;15(12):e51171. doi: 10.7759/cureus.51171. eCollection 2023 Dec.
Benign acute childhood myositis (BACM) is a mild and self-limited sudden onset of lower extremity pain during or following recovery from a viral illness. It is characterized by difficulty walking due to severe bilateral calf pain, which usually resolves in three days. It is typically appreciated during times of large influenza outbreaks and epidemics. The most severe complication can be rhabdomyolysis without proper treatment and can lead to renal damage and potential renal failure. There are limited reported cases of BACM and therefore no clear guidelines in the treatment or management of the condition. This case is unique in the sense that the patient had leg pain the entire month prior to presentation in the absence of trauma or injury, and it is believed that the pre-existing myalgia may have been exacerbated by an upper respiratory infection (URI) that started a few weeks after the leg pain onset. In addition, this patient's creatine kinase peaked at over 13,000 U/L, which is three to five times higher than the average of other reported children with this condition. The patient is a five-year-old male who presented to the emergency department with bilateral leg pain and difficulty ambulating. His guardian reported that the leg pain began one month prior to presentation and worsened to the point where he could no longer ambulate, following a fever and cough that began one week prior to presentation. A respiratory viral panel was positive for influenza B, and initial creatine kinase (CK) levels were greater than 10,000. A diagnosis of BACM was made, and supportive care was initiated. BACM is an infrequent complication following a viral infection that is typically treatable with hydration management and routine CK monitoring. Symptoms of BACM are usually limited to muscle pain and weakness, but it can progress to rhabdomyolysis and renal failure if not managed properly. It is therefore crucial that physicians monitor CK values daily until a downtrend is noticed and symptoms begin to resolve.
良性急性儿童肌炎（BACM）是一种在病毒感染期间或恢复后突然出现的下肢疼痛，病情轻微且具有自限性。其特征是双侧小腿剧痛导致行走困难，通常在三天内缓解。在流感大爆发和流行期间较为常见。若未得到恰当治疗，最严重的并发症可能是横纹肌溶解，进而导致肾损伤和潜在的肾衰竭。关于BACM的报道病例有限，因此在该病症的治疗或管理方面没有明确的指导方针。此病例的独特之处在于，患者在就诊前的整个月内都有腿痛，且无外伤或损伤，据信在腿痛发作几周后开始的上呼吸道感染（URI）可能加剧了原有的肌痛。此外，该患者的肌酸激酶峰值超过13000 U/L，比其他报道的患此病儿童的平均值高三到五倍。患者是一名五岁男性，因双侧腿痛和行走困难到急诊科就诊。其监护人报告称，腿痛在就诊前一个月开始，在就诊前一周出现发热和咳嗽后恶化至无法行走。呼吸道病毒检测显示乙型流感呈阳性，初始肌酸激酶（CK）水平大于10000。诊断为BACM，并开始给予支持性治疗。BACM是病毒感染后一种罕见的并发症，通常通过补液管理和常规CK监测进行治疗。BACM的症状通常仅限于肌肉疼痛和无力，但如果管理不当，可能会发展为横纹肌溶解和肾衰竭。因此，医生必须每天监测CK值，直到发现其呈下降趋势且症状开始缓解。
