PDF(Pubmed)
Abstract：
We present the case of a 17-year-old adolescent boy admitted to the Pediatric Intensive Care Unit with an extensive necrotizing soft tissue infection who subsequently developed altered mental status and autonomic instability. Altered mental status is a common occurrence in critically ill children with a broad differential of etiologies. After ruling out organic causes of encephalopathy, management is typically focused on avoiding deliriogenic agents, including benzodiazepines. Dopamine antagonist medications may also be administered adjunctively to manage agitation or delirium that is refractory to other measures. We review the workup and differential diagnosis for altered mentation in critically ill children and discuss the current understanding of a rare etiology of altered mental status in the pediatric population.
摘要：
我们介绍了一个17岁的青春期男孩，该男孩因广泛的坏死性软组织感染而被送往儿科重症监护病房，随后发生了精神状态改变和自主神经不稳定。在病因差异很大的危重患儿中，精神状态改变是常见的。排除了脑病的器质性原因后,管理通常集中在避免致命剂，包括苯二氮卓类药物.多巴胺拮抗剂药物也可以辅助施用以控制其他措施难以治疗的躁动或谵妄。我们回顾了危重儿童精神改变的检查和鉴别诊断，并讨论了目前对儿科人群中精神状态改变的罕见病因的理解。
