17岁女童COVID-19致死性急性坏死性脑病1例报告

IF 1 Q3 MEDICINE, GENERAL & INTERNAL
Jianming Zhu, Yanling Li, Jianyi Liu, Chaojun Zhou, Xianglin Liu, Yiyi Ding
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引用次数: 0

摘要

背景:急性坏死性脑病(ANE)是一种严重且进展迅速的脑病,主要见于各种全身感染后的儿童。虽然罕见,但ANE病例越来越多地与严重急性呼吸综合征冠状病毒2 (SARS-CoV-2)感染相关。本报告详细介绍了一名被诊断患有2019年冠状病毒病(COVID-19)的17岁女孩发生的致命ANE病例,强调了早期诊断和及时干预以改善临床结果的迫切需要。病例报告:一名先前健康的17岁女孩在SARS-CoV-2检测呈阳性后出现3天发热史,随后出现癫痫发作和意识障碍。颅脑磁共振成像(MRI)显示双侧对称丘脑,是ANE的典型影像学表现。脑脊液(CSF)检查显示细胞计数正常。排除急性弥散性脑脊髓炎(ADEM)和Leigh综合征等鉴别诊断,诊断为ANE。尽管进行了积极的治疗,包括呼吸支持、静脉注射免疫球蛋白和大剂量糖皮质激素,但患者的病情迅速恶化,并于第二天死亡。结论ANE在青少年中是一种罕见但具有破坏性的疾病,特别是在病毒感染(如COVID-19)之后。在病毒感染后出现癫痫发作和进行性意识障碍的患者应考虑使用此药。紧急神经影像学和腰椎穿刺对诊断至关重要。早期识别、免疫治疗和积极的管理对于降低与这种严重神经系统疾病相关的高死亡率至关重要。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Fatal Acute Necrotizing Encephalopathy in a 17-Year-Old Girl with COVID-19: A Case Report.

BACKGROUND Acute necrotizing encephalopathy (ANE) is a severe and rapidly progressive form of encephalopathy predominantly observed in children following various systemic infections. Although rare, cases of ANE have been increasingly associated with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. This report details a fatal case of ANE in a 17-year-old girl diagnosed with coronavirus disease 2019 (COVID-19), emphasizing the critical need for early diagnosis and prompt intervention to improve clinical outcomes. CASE REPORT A previously healthy 17-year-old girl presented with a 3-day history of fever followed by onset of seizures and consciousness disorders after testing positive for SARS-CoV-2. Cranial magnetic resonance imaging (MRI) revealed bilateral symmetrical thalamus, which is a typical imaging presentation of ANE. Cerebrospinal fluid (CSF) examination revealed a normal cell count. Differential diagnoses such as acute disseminated encephalomyelitis (ADEM) and Leigh syndrome were excluded, leading to a diagnosis of ANE. Despite aggressive treatment, including respiratory support, intravenous immunoglobulin, and high-dose glucocorticoids, the patient's condition deteriorated rapidly, resulting in death the following day. CONCLUSIONS ANE is a rare but devastating condition in adolescents, particularly following viral infections such as COVID-19. It should be considered in patients presenting with seizures and progressive consciousness disorders after viral infection. Urgent neuroimaging and lumbar puncture are essential for diagnosis. Early recognition, immunotherapy, and aggressive management are crucial to mitigate the high mortality associated with this severe neurological disorder.

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来源期刊
American Journal of Case Reports
American Journal of Case Reports Medicine-Medicine (all)
CiteScore
1.80
自引率
0.00%
发文量
599
期刊介绍: American Journal of Case Reports is an international, peer-reviewed scientific journal that publishes single and series case reports in all medical fields. American Journal of Case Reports is issued on a continuous basis as a primary electronic journal. Print copies of a single article or a set of articles can be ordered on demand.
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