NEJM:成人手足口病-病例报道

2018-04-05 xing.T MedSci原创

这种疾病是由肠道病毒引起,在年龄小于5岁的儿童中最为常见。通常症状轻微,具有自限性,通过临床症状进行诊断。在罕见的情况下,手足口病会出现严重的并发症,包括脑膜炎、脑炎和心肌炎。

患者为一名36岁的男性,因手掌(图A)和脚底(图B)的水疱以及舌头溃疡(图C)5天而到皮肤科就诊。他还伴有发热、不适和喉咙疼痛。在他发病前一个星期,他2岁和4岁的孩子有类似的症状,他们被诊断为手足口病。



从该病人的右脚底水疱中抽取液体进行逆转录聚合酶链反应,检测到一种肠道病毒;血清学柯萨奇病毒抗体检查确诊为柯萨奇病毒A16。该患者被诊断为手足口病。

这种疾病是由肠道病毒引起,在年龄小于5岁的儿童中最为常见。通常症状轻微,具有自限性,通过临床症状进行诊断。在罕见的情况下,手足口病会出现严重的并发症,包括脑膜炎、脑炎和心肌炎。

接受支持性治疗后,包括非甾体抗炎药治疗,病人的症状减轻。术后2周内手掌病变消失。足部(如图D)和口腔黏膜上的小溃疡病变直到就诊后8周才完全消失。

原始出处:

Chiaki Murase,et al. Hand, Foot, and Mouth Disease in an Adult. N Engl J Med 2018; http://www.nejm.org/doi/full/10.1056/NEJMicm1713548

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  1. [GetPortalCommentsPageByObjectIdResponse(id=1678337, encodeId=2bfd16e8337e8, content=<a href='/topic/show?id=256154569b3' target=_blank style='color:#2F92EE;'>#手足口#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=54569, encryptionId=256154569b3, topicName=手足口)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=bbc627685059, createdName=lingqf, createdTime=Mon Mar 18 04:23:00 CST 2019, time=2019-03-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=313515, encodeId=373d3135156c, content=很不错的病例报告, beContent=null, objectType=article, channel=null, level=null, likeNumber=83, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/y6Sk2KiaDibWSs0icexcRzKWXKao9dILdyaB6olvWApA1uiaapa4T9XMiaU7hTZA04uj2iavabfdCT5iaO6AYue5qSJ7MzXaAVSqh6j/0, createdBy=08e01983553, createdName=执迷不悔, createdTime=Wed May 09 15:35:12 CST 2018, time=2018-05-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=304839, encodeId=5ca23048391c, content=昨天也看到了一个.但是不敢确定啊.现在基本确定了, beContent=null, objectType=article, channel=null, level=null, likeNumber=75, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTKibA62IFMeUJEmSyIe8DvYFeERuOsfrRd8iano7nENqQU1dRR3tqeQOUL3eqgYgEZRT2t2iaEsib0JEw/132, createdBy=66771693911, createdName=易水河, createdTime=Wed Apr 11 17:16:47 CST 2018, time=2018-04-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=302971, encodeId=a8733029e1d6, content=阅, beContent=null, objectType=article, channel=null, level=null, likeNumber=80, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/09/07/a9772c74ffd6edc03a7f9af07b4747f6.jpg, createdBy=b3722138742, createdName=sunfeifeiyang, createdTime=Thu Apr 05 09:39:56 CST 2018, time=2018-04-05, status=1, ipAttribution=)]
    2019-03-18 lingqf
  2. [GetPortalCommentsPageByObjectIdResponse(id=1678337, encodeId=2bfd16e8337e8, content=<a href='/topic/show?id=256154569b3' target=_blank style='color:#2F92EE;'>#手足口#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=54569, encryptionId=256154569b3, topicName=手足口)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=bbc627685059, createdName=lingqf, createdTime=Mon Mar 18 04:23:00 CST 2019, time=2019-03-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=313515, encodeId=373d3135156c, content=很不错的病例报告, beContent=null, objectType=article, channel=null, level=null, likeNumber=83, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/y6Sk2KiaDibWSs0icexcRzKWXKao9dILdyaB6olvWApA1uiaapa4T9XMiaU7hTZA04uj2iavabfdCT5iaO6AYue5qSJ7MzXaAVSqh6j/0, createdBy=08e01983553, createdName=执迷不悔, createdTime=Wed May 09 15:35:12 CST 2018, time=2018-05-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=304839, encodeId=5ca23048391c, content=昨天也看到了一个.但是不敢确定啊.现在基本确定了, beContent=null, objectType=article, channel=null, level=null, likeNumber=75, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTKibA62IFMeUJEmSyIe8DvYFeERuOsfrRd8iano7nENqQU1dRR3tqeQOUL3eqgYgEZRT2t2iaEsib0JEw/132, createdBy=66771693911, createdName=易水河, createdTime=Wed Apr 11 17:16:47 CST 2018, time=2018-04-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=302971, encodeId=a8733029e1d6, content=阅, beContent=null, objectType=article, channel=null, level=null, likeNumber=80, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/09/07/a9772c74ffd6edc03a7f9af07b4747f6.jpg, createdBy=b3722138742, createdName=sunfeifeiyang, createdTime=Thu Apr 05 09:39:56 CST 2018, time=2018-04-05, status=1, ipAttribution=)]
    2018-05-09 执迷不悔

    很不错的病例报告

    0

  3. [GetPortalCommentsPageByObjectIdResponse(id=1678337, encodeId=2bfd16e8337e8, content=<a href='/topic/show?id=256154569b3' target=_blank style='color:#2F92EE;'>#手足口#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=54569, encryptionId=256154569b3, topicName=手足口)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=bbc627685059, createdName=lingqf, createdTime=Mon Mar 18 04:23:00 CST 2019, time=2019-03-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=313515, encodeId=373d3135156c, content=很不错的病例报告, beContent=null, objectType=article, channel=null, level=null, likeNumber=83, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/y6Sk2KiaDibWSs0icexcRzKWXKao9dILdyaB6olvWApA1uiaapa4T9XMiaU7hTZA04uj2iavabfdCT5iaO6AYue5qSJ7MzXaAVSqh6j/0, createdBy=08e01983553, createdName=执迷不悔, createdTime=Wed May 09 15:35:12 CST 2018, time=2018-05-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=304839, encodeId=5ca23048391c, content=昨天也看到了一个.但是不敢确定啊.现在基本确定了, beContent=null, objectType=article, channel=null, level=null, likeNumber=75, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTKibA62IFMeUJEmSyIe8DvYFeERuOsfrRd8iano7nENqQU1dRR3tqeQOUL3eqgYgEZRT2t2iaEsib0JEw/132, createdBy=66771693911, createdName=易水河, createdTime=Wed Apr 11 17:16:47 CST 2018, time=2018-04-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=302971, encodeId=a8733029e1d6, content=阅, beContent=null, objectType=article, channel=null, level=null, likeNumber=80, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/09/07/a9772c74ffd6edc03a7f9af07b4747f6.jpg, createdBy=b3722138742, createdName=sunfeifeiyang, createdTime=Thu Apr 05 09:39:56 CST 2018, time=2018-04-05, status=1, ipAttribution=)]
    2018-04-11 易水河

    昨天也看到了一个.但是不敢确定啊.现在基本确定了

    0

  4. [GetPortalCommentsPageByObjectIdResponse(id=1678337, encodeId=2bfd16e8337e8, content=<a href='/topic/show?id=256154569b3' target=_blank style='color:#2F92EE;'>#手足口#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=54569, encryptionId=256154569b3, topicName=手足口)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=bbc627685059, createdName=lingqf, createdTime=Mon Mar 18 04:23:00 CST 2019, time=2019-03-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=313515, encodeId=373d3135156c, content=很不错的病例报告, beContent=null, objectType=article, channel=null, level=null, likeNumber=83, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/y6Sk2KiaDibWSs0icexcRzKWXKao9dILdyaB6olvWApA1uiaapa4T9XMiaU7hTZA04uj2iavabfdCT5iaO6AYue5qSJ7MzXaAVSqh6j/0, createdBy=08e01983553, createdName=执迷不悔, createdTime=Wed May 09 15:35:12 CST 2018, time=2018-05-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=304839, encodeId=5ca23048391c, content=昨天也看到了一个.但是不敢确定啊.现在基本确定了, beContent=null, objectType=article, channel=null, level=null, likeNumber=75, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTKibA62IFMeUJEmSyIe8DvYFeERuOsfrRd8iano7nENqQU1dRR3tqeQOUL3eqgYgEZRT2t2iaEsib0JEw/132, createdBy=66771693911, createdName=易水河, createdTime=Wed Apr 11 17:16:47 CST 2018, time=2018-04-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=302971, encodeId=a8733029e1d6, content=阅, beContent=null, objectType=article, channel=null, level=null, likeNumber=80, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/09/07/a9772c74ffd6edc03a7f9af07b4747f6.jpg, createdBy=b3722138742, createdName=sunfeifeiyang, createdTime=Thu Apr 05 09:39:56 CST 2018, time=2018-04-05, status=1, ipAttribution=)]
    2018-04-05 sunfeifeiyang

    0

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