Open-access Acute necrotizing encephalopathy, a challenging diagnosis in a child with sudden neurological deterioration

Abstract

Acute necroziting encephalopathy (ANE) is a rare and serious entity, with significant neurological involvement, in which the radiological findings of symmetric and multifocal necroziting lesions in central nervous system are characteristic. It is an immune-mediated disease with incompletely recognized pathogenesis. We present the case of a 1 year old child, previously healthy, that presented with acute neurological deterioration after a day of fever and seizures. She required reanimation and ventilation. Typical findings of ANE were found in neuroimaging and she was treated with inmunomodulating therapy, antibiotics and antivirals. Only rhinovirus and adenovirus were isolated in respiratory sample. The patient survived with significant neurological sequelae. This is the first case of ANE published in Costa Rica.

Keywords: acute febrile encephalopathy; nervous system diseases; seizures

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None Apdo. 548-1000, Sabana Sur, San José, Costa Rica, San José, San José, CR, 504-1000, 2210-2200, 22102279 - E-mail: actamedica@medicos.cr
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