老年医学跨学科团队综合干预治疗单纯疱疹病毒感染继发右侧声带麻痹老年患者一例

A Case of Older Patient with Right Vocal Cord Paralysis Caused by Herpes Simplex Virus Infection Using Comprehensive Intervention by a Geriatric Interdisciplinary Team

  • 摘要: 本文报道1例老年医学跨学科团队综合干预治疗单纯疱疹病毒感染继发右侧声带麻痹的老年患者。该患者临床表现为发热、口唇及右颊部水疱,并逐渐出现声嘶及吞咽困难。喉镜检查见右侧声带固定,左侧声带活动正常。病程中检测出单纯疱疹病毒1型IgM高滴度阳性。经中等剂量糖皮质激素及甲钴胺营养神经治疗,联合吞咽及发声康复训练、肠内营养支持后,患者声嘶减轻,可分次小口饮水,复查喉镜见右侧声带部分恢复运动。本文总结该患者的诊治经过并复习相关文献,以期提高临床医师对该病的认识,并了解老年医学跨学科团队在复杂老年疾病诊疗中的重要作用。

     

    Abstract: This article presents a case report of right vocal cord paralysis resulting from herpes simplex virus infection in an older adult. The patient initially presented with fever, blisters on the lips and right cheek, followed by the gradual onset of hoarseness and difficulty in swallowing. Laryngoscopy revealed fixation of the right vocal cord while the left vocal cord exhibited normal movement. A high level of herpes simplex virus type 1 IgM antibody was detected during the disease progression. Treatment involving mid-dose glucocorticoid and methylcobalamin neurotrophic therapy, swallowing and vocal rehabilitation training, as well as enteral nutrition support, led to alleviation of hoarseness and improved ability to drink water in small sips. Follow-up laryngoscopy indicated partial restoration of movement in the right vocal cord. The article not only outlines the diagnosis and treatment of this case but also reviews relevant literature to broaden clinicians' knowledge of viral-induced vocal cord paralysis in the elderly. It also emphasizes the importance of a geriatric interdisciplinary team in managing complex diseases in older patients.

     

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