ICNC Abstracts, ICNC 2018

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Atypical CNS infection: needs a mention.
abhijeet vilas botre

Last modified: 2018-09-09

Abstract


Introduction: Febrile encephalopathy is common presentation of neurological illness in paediatric population.Etiologies include infections, immunological, epileptic and metabolic conditions.We present a case with acute febrile encephalopathy resulting from Human Paraechvirus.

Case report: 14 months girl, admitted with acute febrile coryzal illness followed by seizures in clusters and altered sensorium. On examination Encephalopthic , Hypertonia in LL > UL brisk DTR ankle clonus ++  Plantar extensors .Blood & CSF studies:  Normal. Basic metabolic screen : normal.MRI showed nonspecific white matter changes. CSF viral panel: HPeV PCR +ve .Treatment: anticonvulsants, antibiotics and acyclovir and steroids. Course: Slowly improved with altered sleep cycle and motor regression. Within 1 month of discharge, became normal, no deficit

Discussion: Majority of acute CNS infections are due to bacterial and viral etiology.. Still viral meningoencepahlits is not easy to diagnose because of poor utility of specific viral panel (apart from HSV) and radiological facility. It mainly causes neonatal infection but can be seen in young infants though rare. HPeV presents as sepsis like illness or febrile encepahlopathy in neonates resulting into major motor (spastic diaplegia) and cognitive sequel. Radiologically they show features of acute HIE or PVL. There are no case reports of CNS HPeV infection from India in apart from neonatal period in literature.

Conclusion: PCR based neuropathic panel should be done to confirm the organism as well as for epidemiological surveillance. Supportive and symptomatic treatment should be offered in cases of HPeV and recovery is variable.


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