w**********9
发帖数: 242 | 1 A 5-year-old healthy boy suddenly died. He developed flu-like illness with
cough, cold, and fever and was treated with amoxicillin two weeks ago. He
developed severe anorxia thereafter. Following episodes of vomiting, he lost
consciousness. He was sent to ER, and his vital signs were absent and
resuscitation was unsuccessful.On the pathology, he has a biventricular
hypertrophy, clusters of interstitial lymphocytes and fibrosis associated
with myocardium degeneration. The dorsal root ganglion sho |
y*****g
发帖数: 193 | 2 meningitis complicated with pericarditis? |
t*******n
发帖数: 4445 | 3 enterovirus?
wondering what could have been done for better outcome...
lost
The
gracile
【在 w**********9 的大作中提到】
: A 5-year-old healthy boy suddenly died. He developed flu-like illness with
: cough, cold, and fever and was treated with amoxicillin two weeks ago. He
: developed severe anorxia thereafter. Following episodes of vomiting, he lost
: consciousness. He was sent to ER, and his vital signs were absent and
: resuscitation was unsuccessful.On the pathology, he has a biventricular
: hypertrophy, clusters of interstitial lymphocytes and fibrosis associated
: with myocardium degeneration. The dorsal root ganglion sho
|
w**********9
发帖数: 242 | 4 several elements are important
1), bi-ventricular hypertrophy
2), ventricular muscle degeneration
3), interstitial lymphocytes infiltration in ventricular muscle
4), Sensory nervous system is impaired. Lesioned DRG + dorsal column + doral
nucleis in medulla-----> should be Romberg sign(+)--->ataxia |
g*****j
发帖数: 1211 | 5 This is a hard one:) Several viruses may potentially lead to this clinical
picture in rare situations.
I am thinking of Coxsackie B, Herpes etc.
Is that a real case? |
w**********9
发帖数: 242 | 6 Viral infection seems approved by everyone.
But, how can we explain the ventricular hypertrophy, fibrosis and muscle
degeneration ? |
n******s
发帖数: 210 | 7 sounds like a question from qbank, most likely step1. |
w**********9
发帖数: 242 | 8 蜗牛同学整过step1了?.
qbank 究竟有没有这个? 俺不知道
【在 n******s 的大作中提到】
: sounds like a question from qbank, most likely step1.
|
n******s
发帖数: 210 | 9 I can not recall, but seems like. |
w**********9
发帖数: 242 | 10 不是qbank, 是我做research时看到的一个case. 很有意思. 我觉得作者讲的不清楚.
所想看看大家怎么说. hypertrophic ventricle indicates a congenital disease that affects both nervous system and heart. acute viral myocarditis is very likely and encephalitis (or encephalomyelitis) is also an interesting perspective, which is what the authors did not mention while focusing on the congenital disease.
【在 n******s 的大作中提到】
: I can not recall, but seems like.
|
n******s
发帖数: 210 | 11 seems it is kind of immuno reaction to certain virus,
carditis, and demyelination of CNS, something like MS or GBS. |
