ABSTRACT

A 7-month-old boy was admitted with acute gastro-enteritis accompanied by fever and hyponatraemic dehydration. The clinical course was complicated by severe hypokalaemia and hypo-albuminaemia with anasarca. Protein-losing enteropathy (PLE) owing to Yersinia enterocolitica colitis was diagnosed and was complicated by fungal sepsis owing to Kodomaea ohmeri. Colonoscopy demonstrated multiple diffuse ulcers and sub-epithelial haemorrhages extending from the rectum to the hepatic angle. He required prolonged nutritional support comprising partial parenteral feeding for 10 days, followed by a hypo-allergenic diet until 13 months of age when cow milk was tolerated. He was discharged on a normal diet and in good health at 19 months of age.

Abbreviations AVPU scale: A alert, V verbally responsive, P painfully responsive, U unresponsive; CMV: cytomegalovirus; EBV: Epstein–Barr virus; HIV: human immunodeficiency virus; Ig: immunoglobulin; IBD: inflammatory bowel disease; IPEX: immune dysregulation, polyendocrinopathy, enteropathy, X-linked syndrome; PICU: paediatric intensive care unit; PLE: protein-losing enteropathy

摘要

一名 7 个月大的男孩因急性胃肠炎伴发热和低钠性脱水入院。临床过程因严重低钾血症和低白蛋白血症伴全身性水肿而复杂化。由耶尔森菌肠结肠炎引起的蛋白质丢失性肠病 (PLE)被诊断为因Kodomaea ohmeri引起的真菌性败血症。结肠镜检查显示多处弥漫性溃疡和从直肠延伸至肝角的上皮下出血。他需要延长营养支持，包括 10 天的部分肠外喂养，然后是低过敏性饮食，直到 13 个月大时可以耐受牛奶。他在 19 个月大时以正常饮食和健康状况出院。

缩写AVPU 量表：A 警报，V 口头反应，P 痛苦反应，U 无反应；CMV：巨细胞病毒；EBV：爱泼斯坦-巴尔病毒；HIV：人类免疫缺陷病毒；Ig：免疫球蛋白；IBD：炎症性肠病；IPEX：免疫失调、多内分泌病、肠病、X连锁综合征；PICU：儿科重症监护室；PLE：蛋白质丢失性肠病