Acute Necrotizing Encephalopathy – A Rare Complication of H1N1 Infection
Autor(a) principal: | |
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Data de Publicação: | 2018 |
Outros Autores: | , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
Texto Completo: | https://doi.org/10.25753/BirthGrowthMJ.v27.i2.11721 |
Resumo: | Acute necrotizing encephalopathy is a rare complication of H1N1 influenza infection, more prevalent in preschool children. It is characterized by a rapid neurological deterioration with progressive decline on the level of consciousness in the context of a febrile disease, associated with multifocal symmetric brain lesions. The cases of two children (two and four years old) admitted due to an altered level of conscience in the context of febrile respiratory infection are described. The laboratory studies disclosed high aminotransferases with normal ammonia, and the presence of H1N1 virus in the nasopharyngeal swab. The brain computed tomography showed bilateral thalamic hypodensities. The clinical evolution was very distinctive in the two cases, with brain death in one and survival with good neurological outcome in the other. The association of febrile respiratory infection and a rapid decline on the level of consciousness should be an alert to this entity, which has high morbidity and mortality. For the diagnosis, it is recommended to search for the virus in the nasopharyngeal swab. In addition to supportive treatment, oseltamivir and immunomodulators, although controversial, are the most commonly used therapies. |
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Acute Necrotizing Encephalopathy – A Rare Complication of H1N1 InfectionEncefalopatia aguda necrosante - complicação rara de infeção por H1N1Case ReportsAcute necrotizing encephalopathy is a rare complication of H1N1 influenza infection, more prevalent in preschool children. It is characterized by a rapid neurological deterioration with progressive decline on the level of consciousness in the context of a febrile disease, associated with multifocal symmetric brain lesions. The cases of two children (two and four years old) admitted due to an altered level of conscience in the context of febrile respiratory infection are described. The laboratory studies disclosed high aminotransferases with normal ammonia, and the presence of H1N1 virus in the nasopharyngeal swab. The brain computed tomography showed bilateral thalamic hypodensities. The clinical evolution was very distinctive in the two cases, with brain death in one and survival with good neurological outcome in the other. The association of febrile respiratory infection and a rapid decline on the level of consciousness should be an alert to this entity, which has high morbidity and mortality. For the diagnosis, it is recommended to search for the virus in the nasopharyngeal swab. In addition to supportive treatment, oseltamivir and immunomodulators, although controversial, are the most commonly used therapies.A encefalopatia aguda necrosante é uma complicação rara da infeção pelo vírus H1N1, mais prevalente na idade pré-escolar. Caracteriza-se por um quadro neurológico rapidamente progressivo, com deterioração do estado de consciência em contexto de doença febril, associado a lesões cerebrais multifocais simétricas. Descrevem-se os casos de duas crianças com dois e quatro anos, admitidas por alteração do estado de consciência em contexto de infeção respiratória febril (IRF). Dos exames complementares realizados, destacavam-se aminotransferases elevadas com amónia normal, presença do vírus H1N1 no aspirado nasofaríngeo (ANF) e hipodensidades talâmicas bilaterais na tomografia computorizada cerebral. A evolução foi distinta, com morte cerebral num dos casos e sobrevida com boa evolução neurológica no outro caso. No contexto de IRF, a alteração rapidamente progressiva do estado de consciência deve alertar para esta entidade, que tem elevada morbimortalidade. Está recomendada a pesquisa do vírus no ANF para a confirmação do diagnóstico. Além do tratamento de suporte, a terapêutica com oseltamivir e imunomodeladores, ainda que controversa, é a mais utilizada.Centro Hospitalar Universitário do Porto2018-07-13T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articlehttps://doi.org/10.25753/BirthGrowthMJ.v27.i2.11721eng2183-9417Martins, Andreia AlvesDias, InêsDias, AndreaMoinho, RitaPinto, CarlaCarvalho, Leonorinfo:eu-repo/semantics/openAccessreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAP2022-09-21T14:55:24Zoai:ojs.revistas.rcaap.pt:article/11721Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T15:56:23.543141Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse |
dc.title.none.fl_str_mv |
Acute Necrotizing Encephalopathy – A Rare Complication of H1N1 Infection Encefalopatia aguda necrosante - complicação rara de infeção por H1N1 |
title |
Acute Necrotizing Encephalopathy – A Rare Complication of H1N1 Infection |
spellingShingle |
Acute Necrotizing Encephalopathy – A Rare Complication of H1N1 Infection Martins, Andreia Alves Case Reports |
title_short |
Acute Necrotizing Encephalopathy – A Rare Complication of H1N1 Infection |
title_full |
Acute Necrotizing Encephalopathy – A Rare Complication of H1N1 Infection |
title_fullStr |
Acute Necrotizing Encephalopathy – A Rare Complication of H1N1 Infection |
title_full_unstemmed |
Acute Necrotizing Encephalopathy – A Rare Complication of H1N1 Infection |
title_sort |
Acute Necrotizing Encephalopathy – A Rare Complication of H1N1 Infection |
author |
Martins, Andreia Alves |
author_facet |
Martins, Andreia Alves Dias, Inês Dias, Andrea Moinho, Rita Pinto, Carla Carvalho, Leonor |
author_role |
author |
author2 |
Dias, Inês Dias, Andrea Moinho, Rita Pinto, Carla Carvalho, Leonor |
author2_role |
author author author author author |
dc.contributor.author.fl_str_mv |
Martins, Andreia Alves Dias, Inês Dias, Andrea Moinho, Rita Pinto, Carla Carvalho, Leonor |
dc.subject.por.fl_str_mv |
Case Reports |
topic |
Case Reports |
description |
Acute necrotizing encephalopathy is a rare complication of H1N1 influenza infection, more prevalent in preschool children. It is characterized by a rapid neurological deterioration with progressive decline on the level of consciousness in the context of a febrile disease, associated with multifocal symmetric brain lesions. The cases of two children (two and four years old) admitted due to an altered level of conscience in the context of febrile respiratory infection are described. The laboratory studies disclosed high aminotransferases with normal ammonia, and the presence of H1N1 virus in the nasopharyngeal swab. The brain computed tomography showed bilateral thalamic hypodensities. The clinical evolution was very distinctive in the two cases, with brain death in one and survival with good neurological outcome in the other. The association of febrile respiratory infection and a rapid decline on the level of consciousness should be an alert to this entity, which has high morbidity and mortality. For the diagnosis, it is recommended to search for the virus in the nasopharyngeal swab. In addition to supportive treatment, oseltamivir and immunomodulators, although controversial, are the most commonly used therapies. |
publishDate |
2018 |
dc.date.none.fl_str_mv |
2018-07-13T00:00:00Z |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
https://doi.org/10.25753/BirthGrowthMJ.v27.i2.11721 |
url |
https://doi.org/10.25753/BirthGrowthMJ.v27.i2.11721 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
2183-9417 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.publisher.none.fl_str_mv |
Centro Hospitalar Universitário do Porto |
publisher.none.fl_str_mv |
Centro Hospitalar Universitário do Porto |
dc.source.none.fl_str_mv |
reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação instacron:RCAAP |
instname_str |
Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
instacron_str |
RCAAP |
institution |
RCAAP |
reponame_str |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
collection |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
repository.name.fl_str_mv |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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1799130432522944512 |