发烧和腿痛:考虑所有的诊断

IF 1.3 Q2 MEDICINE, GENERAL & INTERNAL Ochsner Journal Pub Date : 2019-06-20 DOI:10.31486/toj.18.0122
Lesley N. Desmond, Matthew Fletcher, R. Warrier
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引用次数: 1

摘要

背景:急性淋巴细胞白血病(ALL)是美国诊断的最常见的儿童癌症。这种疾病会导致造血功能下降,因此儿童经常出现贫血、血小板减少和白细胞减少等症状。这种恶性肿瘤的症状可能与骨髓炎等其他疾病有显著重叠。病例报告:一名2岁男性,无明显病史,表现为下肢疼痛和发烧。包括影像学和全血细胞计数在内的初步调查使医生诊断出双侧骨髓炎。给病人开了一个疗程的抗生素;然而,他的症状又回来了。最终,骨髓穿刺显示CD99膜阳性的小圆蓝细胞肿瘤。患者被诊断为急性淋巴细胞白血病。他成功地接受了化疗,目前病情缓解。结论:该病例证明了对儿童腿部疼痛和发烧进行广泛鉴别诊断的重要性。
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Fever and Leg Pain: Consider ALL the Diagnoses
Background: Acute lymphoblastic leukemia (ALL) is the most common childhood cancer diagnosed in the United States. The disease causes a decrease in hematopoiesis, so children often present with symptoms related to anemia, thrombocytopenia, and leukopenia. Symptoms for this malignancy may have significant overlap with other conditions such as osteomyelitis. Case Report: A 2-year-old male with no significant medical history presented with lower extremity pain and fever. Initial investigations, including imaging and complete blood count, led physicians to diagnose bilateral osteomyelitis. The patient was prescribed a course of antibiotics; however, his symptoms returned. Eventually, a bone marrow aspiration showed CD99 membrane–positive small round blue cell tumors. The patient was diagnosed with ALL. He was successfully treated with chemotherapy and is now in remission. Conclusion: This case demonstrates the importance of a broad differential diagnosis for a child presenting with leg pain and fever.
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来源期刊
Ochsner Journal
Ochsner Journal MEDICINE, GENERAL & INTERNAL-
CiteScore
2.10
自引率
0.00%
发文量
71
审稿时长
24 weeks
期刊介绍: The Ochsner Journal is a quarterly publication designed to support Ochsner"s mission to improve the health of our community through a commitment to innovation in healthcare, medical research, and education. The Ochsner Journal provides an active dialogue on practice standards in today"s changing healthcare environment. Emphasis will be given to topics of great societal and medical significance.
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