Miao Miao (pseudonym) from Shaoyang, Hunan Province, is 17 years old this year, usually introverted, loves to play games, 10 days ago at school suddenly appeared mental abnormalities, gibberish, mouth saying some games in the fight and kill, do not know the family, do not eat. This frightened the parents, thinking that Miao Miao was mentally ill, and quickly took Miao Miao from her hometown to the psychiatric department of Hunan Provincial Brain Hospital (Hunan Second People's Hospital).
However, on the night before coming to Changsha to see a doctor, the family was staying in a hotel, and Miao Miao had an accident. At night, Miao Miao heard the sound of opening the window, was frightened and suddenly jumped out of bed and rushed out of the door, her mother rushed forward to chase, as a result, Miao Miao accidentally fell down the stairs of the hotel, resulting in a fracture of the left lower limb, Miao Miao was in pain. The family took Miao Miao to the psychiatric department for treatment, the doctor found that Miao Miao's mental abnormalities were not the same as typical mental illness, and then Miao Miao had a fever, a body temperature of 38.6 ° C, followed by drowsiness, after careful examination by the doctor, it was considered to be "encephalitis".
Miao Miao immediately transferred to the Department of Neurology, the doctor in charge Ofi Associate Professor Wu Shixing for Miao Miao did a series of complete examinations such as lumbar puncture, blood culture, pelvic X-ray and CT, and found that the white blood cell count of cerebrospinal fluid was 2 * 106 / L, the total number of cells was 4 * 106 / L, the total protein was 612.2 mg / L (normal 150 ~ 400 mg / L) The nervous system examination prompted: cervical resistance (++) Keb's sign (+) bilateral Pap sign positive, positive blood culture, considering the possibility of viral encephalitis, And there is a left femoral neck fracture, sepsis, the current condition is critical, if not treated in time, may be further aggravated, at any time there will be impaired consciousness, water and electrolyte disorders, multi-organ failure, septic shock, life-threatening.
lumbar puncture
Director Xiang Guanghong of the fourth ward of the Department of Neurology rounds
After the diagnosis was clear, Associate Professor Wu Shixing formulated a detailed treatment plan for Miao Miao, carried out symptomatic treatment such as intracranial pressure reduction, anti-infection, anti-virus and other symptomatic treatment, after more than 10 days of treatment, miao Miao turned critical to safety, body temperature returned to normal, no nonsense, can simply communicate and answer, the doctor intends to transfer to the orthopedic department for femoral neck surgery.
Associate Professor Wu Shixing reminded that viral encephalitis is an acute onset of a disease caused by the direct invasion of the brain parenchyma by the virus, which is more common in young people.
If headache and fever suddenly appear like cold-like symptoms, mental abnormalities, dementia, unconsciousness, epilepsy, noisy running, do not eat, and even have the illusion of being killed and other mental symptoms, should be vigilant about the occurrence of encephalitis, at this time parents should pay special attention to 24-hour companionship, protect the personal safety of patients, to prevent the occurrence of suicide and self-injury and escape.
Viral encephalitis can be prevented: reduce going to public places, pay attention to wearing masks during the virus epidemic season, wash hands frequently, young people avoid staying up late to play games, develop a good lifestyle, exercise appropriately, give high-protein, high-calorie, high-vitamin diets, improve the body's immunity, prevent the occurrence of colds and intestinal infections, and once viral encephalitis occurs, it is necessary to treat medical treatment as soon as possible, so as not to delay the disease and cause serious consequences and even endanger life.
Contributed by: Zhou Weiying, Department of Neurology, Second People's Hospital of Hunan Province (Hunan Brain Hospital).
Editor: Liu Yuchen
Image: From the Internet, intrusion and deletion