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.

中文翻译：

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“看看他们的心” 7 岁男孩患有镰状细胞病、发烧、左第六和第七脑神经麻痹和左偏瘫

一名 7 岁的利比里亚男孩出现发烧、剧烈头痛、颈部疼痛和“无法行走”。在急诊室，他的镰状细胞筛查呈阳性，血红蛋白水平为 7 g/dl。最初，他因诊断为镰状细胞疼痛危象而住进病房，并接受了头孢曲松静脉注射、口服吗啡和扑热息痛治疗。在更完整的体格检查中，他有左外周第七神经麻痹、左第六神经麻痹和同侧偏瘫，还有颈部强直。在床边超声扫描中，他在二尖瓣的主动脉瓣上有一个大的、可移动的植被。最终诊断为患有镰状细胞病的儿童患有急性感染性心内膜炎并伴有多次栓塞性中风。头痛和颈部僵硬最可能是由于 SAH 或脑膜炎。