J Endod:出现类似于牙齿疼痛的神经性疾病患者的诊断:莱姆病

2020-07-14 lishiting 网络

这篇病例汇报描述的是一名发展为神经性疾病的患者出现类似于牙齿疼痛的症状,随后被诊断为莱姆病。

这篇病例汇报描述的是一名发展为神经性疾病的患者出现类似于牙齿疼痛的症状,随后被诊断为莱姆病。

一名健康的女性患者就诊于牙髓病专科医生并报告存在牙齿疼痛的症状。她的症状包括左下颌剧烈疼痛放散至颞肌区域并贯通颈部,同时左下唇及舌体左侧麻木。她也报告有夜前畏寒和发汗的感觉,同时肩膀和手臂知觉改变。非处方止疼药不能缓解疼痛。口内和放射线检查并未发现任何异常,患者存在以下鉴别诊断:1)心脏病;2)三叉神经痛;3)颞下颌关节功能障碍。患者当天在当地医院的急诊室也进行了诊断和评估,经过一些检查排除了中风和心肌梗塞。第二天,她注意到在她左侧大腿上后部区域出现一块肿胀伴随靶心样红斑。同日,患者就诊于其家庭医生,并诊断为莱姆病。

由于莱姆病的症状可能与牙疼相似,口腔医生应该知晓莱姆病的临床表现。莱姆病应该被认为是可能出现在口面部区域存在相符症状和指征患者的鉴别诊断。

原始出处

Isabel Mello, John Peters, et al. Neuropathy mimicking dental pain on a patient diagnosed with Lyme disease. J Endod., 2020 Jun 17;S0099-2399(20)30401-5. doi: 10.1016/j.joen.2020.06.011.

 

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    2020-07-16 zhouqu_8
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    2020-07-15 qingfengqishi5

    学习了,学习了

    0

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    2020-07-14 ms8000001231871759

    莱姆病

    0

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此病例提醒临床医生,有黄疸、脾大,不但要考虑有肝硬化的可能,也要考虑是否有肝外病变,尤其是术后血象“三系”仍偏低且伴有发热、黄疸,也需要警惕淋巴瘤!