六岁儿童长期头痛:意想不到的脑膜炎模拟病例

Jennifer Hadjiev, James McCarthy, Leann Madion, Lileth Mondok
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引用次数: 0

摘要

发烧并伴有头痛和呕吐,这对临床医生来说是一个警示,可适当触发脑膜炎和其他危及生命诊断的评估。如果在排除了这些病症后症状仍持续存在,病人护理就会变得更具挑战性。我们介绍的病例是一名有自闭症谱系障碍病史的 6 岁男性患者,他出现头痛 6 个月,伴有呕吐和间歇性发热,尽管脑脊液多细胞增多,但感染性检查结果为阴性。通过连续的神经影像学检查和实验室评估,最终确诊为髓鞘少突胶质细胞糖蛋白抗体相关疾病(MOGAD),表现为无菌性脑膜炎。髓鞘少突胶质细胞糖蛋白抗体相关性疾病(MOGAD)的临床和影像学表现千变万化,并与其他几种炎症性疾病重叠,因此诊断具有挑战性。本病例强调了将这种罕见的 MOGAD 表现识别为感染性脑膜炎模拟病的重要性。
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Six Year Old With Chronic Headache: An Unexpected Meningitis Mimic.

The constellation of fevers accompanied by headache and vomiting is a red flag for clinicians that appropriately triggers evaluation for meningitis and other life-threatening diagnoses. When symptoms persist even after these conditions are ruled out, patient care becomes more challenging. We present the case of a 6-year-old male with a history of autism spectrum disorder who presented with 6 months of headaches and associated vomiting and intermittent fevers with negative infectious workup despite cerebrospinal fluid pleocytosis. Serial neuroimaging and laboratory evaluation ultimately led to a diagnosis of myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) presenting as aseptic meningitis. The clinical and radiographic findings of MOGAD are widely variable and overlap with several other inflammatory conditions, which makes diagnosis challenging. This case highlights the importance of recognizing this rare MOGAD presentation as an infectious meningitis mimic.

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