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与 Chiari 畸形 I 型患儿 SARS-CoV-2 感染相关的脑炎。

Encephalitis Associated With SARS-CoV-2 Infection in a Child With Chiari Malformation Type I.

机构信息

Unidad Médica de Alta Especialidad, Hospital de Especialidades No. 14, Centro Médico Nacional "Adolfo Ruiz Cortines", Instituto Mexicano del Seguro Social (IMSS), Veracruz, Mexico.

Facultad de Medicina, Región Veracruz, Universidad Veracruzana (UV), Veracruz, Mexico.

出版信息

In Vivo. 2023 Mar-Apr;37(2):933-939. doi: 10.21873/invivo.13165.

Abstract

BACKGROUND/AIM: There is increasing evidence that patients infected with SARS-CoV-2 develop neurological manifestations such as encephalitis. The purpose of this article was to present a case of viral encephalitis associated with SARS-CoV-2 in a 14-year-old child with Chiari malformation type I.

CASE REPORT

The patient manifested frontal headache, nausea, vomiting, skin pallor, right side Babinski sign and was diagnosed with Chiari malformation type I. He was admitted with generalized seizures and suspected encephalitis. Brain inflammation and viral RNA in the cerebrospinal fluid suggested SARS-CoV-2 encephalitis. These findings indicate that the SARS-CoV-2 test in CSF of patients with neurological manifestations, confusion, and fever during the COVID-19 pandemic should be carried out even when there is no evidence of respiratory infection. To our knowledge, this presentation of encephalitis associated with COVID-19 has not yet been reported in a patient with a congenital syndrome such as Chiari malformation type I.

CONCLUSION

Further clinical data are needed to determine the complications of encephalitis due to SARS-CoV-2 in patients with Chiari malformation type I to standardize diagnosis and treatment.

摘要

背景/目的:越来越多的证据表明,感染 SARS-CoV-2 的患者会出现脑炎等神经系统表现。本文旨在报告 1 例伴有 Chiari 畸形 I 型的 SARS-CoV-2 相关病毒性脑炎的儿童病例。

病例报告

该患者表现为额头痛、恶心、呕吐、皮肤苍白、右侧巴氏征阳性,被诊断为 Chiari 畸形 I 型。他因全身发作和疑似脑炎入院。脑炎症和脑脊液中的病毒 RNA 提示 SARS-CoV-2 脑炎。这些发现表明,即使没有呼吸道感染的证据,在 COVID-19 大流行期间,对出现神经系统表现、意识混乱和发热的患者进行脑脊液 SARS-CoV-2 检测也很重要。据我们所知,这种与 COVID-19 相关的脑炎在伴有 Chiari 畸形 I 型等先天性综合征的患者中尚未有报道。

结论

需要进一步的临床数据来确定 Chiari 畸形 I 型患者因 SARS-CoV-2 引起的脑炎的并发症,以规范诊断和治疗。

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