期刊
JOURNAL OF TROPICAL PEDIATRICS
卷 67, 期 3, 页码 -出版社
OXFORD UNIV PRESS
DOI: 10.1093/tropej/fmab057
关键词
stroke; infective endocarditis; meningitis; mitral valve vegetation; sickle cell disease; sub-arachnoid haemorrhage
A 7-year-old Liberian boy presented with fever, severe headache, neck pain and 'not being able to walk'. The final diagnosis was acute infective endocarditis with multiple embolic strokes in a child with sickle cell disease.
A 7-year-old Liberian boy presented with fever, severe headache, neck pain and 'not being able to walk'. In the emergency room, his sickle cell screen was positive, and his haemoglobin level was 7 g/ dl. Initially, he was admitted to the ward with a diagnosis of sickle cell painful crisis and was treated with ceftrixone iv, and oral morphine and paracetamol. In a more complete physical examination, he had left peripheral seventh nerve palsy, left sixth nerve palsy and ipsilateral hemiplegia, also neck rigidity. In a bedside ultrasound scan, he had a large, mobile vegetation on the aortic leaflet of the mitral valve. The final diagnosis was acute infective endocarditis with multiple embolic strokes in a child with sickle cell disease. Headache and neck rigidity was most likely due to SAH or meningitis.
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