Volume 34, Issue 241 (1-2025)
J Mazandaran Univ Med Sci 2025, 34(241): 126-132 |
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Mobedi M. Acute Necrotizing Encephalopathy and Death in a Six‒Year‒Old Iranian Child Infected with Influenza A H3N2. J Mazandaran Univ Med Sci 2025; 34 (241) :126-132
URL: http://jmums.mazums.ac.ir/article-1-20310-en.html
URL: http://jmums.mazums.ac.ir/article-1-20310-en.html
Abstract: (469 Views)
Acute necrotizing encephalopathy (ANE) is a rare but severe neurological condition characterized by rapid deterioration of the patient's cognitive and motor functions, often accompanied by seizures, altered consciousness, and coma. This condition can be triggered by various pathogenic factors including viral infections such as influenza and the coronavirus. Initially reported in East Asia, particularly in Japan, ANE has since been documented in other regions globally, with a marked increase in cases associated with the coronavirus in recent years. This article presents the case of a six-year-old Iranian girl who developed acute necrotizing encephalopathy following an acute respiratory illness characterized by fever and convulsions. The patient had no previous medical history or known exposure to influenza, nor had she received influenza vaccination. She was brought to the emergency department by her parents after two days of fever, headache, muscle pain, and sore throat, presenting with seizures, a reduced level of consciousness, and hemodynamic instability. Upon admission to the pediatric intensive care unit (ICU), initial interventions included stabilizing vital signs, administering serum therapy, prescribing antibiotics, and conducting diagnostic tests such as COVID-19 and influenza screening. Further diagnostic and therapeutic measures included brain imaging, which confirmed the diagnosis of acute necrotizing encephalopathy. As part of the treatment protocol, the patient received intravenous immunoglobulin and corticosteroids. Despite aggressive management, including intubation and intensive care, the patient's condition deteriorated rapidly due to extensive involvement of the brainstem and the onset of multiple organ failure. Unfortunately, despite the best efforts of the medical team, the patient passed away. While several cases of acute necrotizing encephalopathy have been documented in East Asia and other parts of the world, reports from Iran remain scarce. This case highlights the importance of considering acute necrotizing encephalopathy in the differential diagnosis of children who experience progressive neurological decline following an acute febrile illness.
Type of Study: Case Report |
Subject:
Pediatric Neurology
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