Huang Qiuling, Zhou Ruoyi, Zhang Yean, Li Jie, Yu Feng
Department of Pediatrics, Fifth School of Clinical Medicine of Zhejiang Chinese Medical University, Huzhou Central Hospital, Affiliated Central Hospital of Huzhou University, Huzhou, Zhejiang, China.
Department of Pharmacy, Fifth School of Clinical Medicine of Zhejiang Chinese Medical University, Huzhou Central Hospital, Affiliated Central Hospital of Huzhou University, Huzhou, Zhejiang, China.
Front Pediatr. 2024 Dec 11;12:1480514. doi: 10.3389/fped.2024.1480514. eCollection 2024.
Paroxysmal sympathetic hyperactivity (PSH) syndrome often occurs with severe traumatic brain injury. However, it can also occur during infections, such as severe bacterial meningoencephalitis in children. is an aggressive, virulent, opportunistic pathogen. This species can cause meningoencephalitis in children, as reported in a few cases.
A five-year-old boy with no relevant past medical history was admitted to a hospital because of a fever and progressive disturbance of consciousness. His head computed tomography scan and magnetic resonance imaging revealed extensive brain damage and an intraventricular abscess. A next-generation sequencing technology test performed on his cerebrospinal fluid revealed that the child's meningoencephalitis was caused by . During treatment, the child had clinical manifestations such as fever, tachycardia, tachypnea, diaphoresis, and hypertension. Changes in muscle tone and abnormal posture, which were misdiagnosed as epilepsy at the early treatment stage, were also observed; however, anti-epileptic treatment was ineffective. The child was diagnosed with PSH and received the appropriate treatment, and his symptoms eventually improved.
To our knowledge, this is the first case report on PSH induced by meningoencephalitis. Early identification, diagnosis, and treatment of PSH are crucial.
阵发性交感神经过度兴奋（PSH）综合征常与重度创伤性脑损伤同时发生。然而，它也可能在感染期间出现，比如儿童严重细菌性脑膜脑炎。是一种侵袭性、毒性强的机会致病菌。据少数病例报道，该菌种可导致儿童脑膜脑炎。
一名无相关既往病史的5岁男孩因发热和意识进行性障碍入院。他的头部计算机断层扫描和磁共振成像显示广泛脑损伤和脑室内脓肿。对其脑脊液进行的下一代测序技术检测显示，该儿童的脑膜脑炎由引起。治疗期间，该儿童出现发热、心动过速、呼吸急促、多汗和高血压等临床表现。还观察到肌张力变化和异常姿势，在治疗早期被误诊为癫痫；然而，抗癫痫治疗无效。该儿童被诊断为PSH并接受了适当治疗，其症状最终得到改善。
据我们所知，这是首例关于由脑膜脑炎诱发PSH的病例报告。早期识别、诊断和治疗PSH至关重要。
