Case Presentation of a 23-Month-old Herpes Simplex Virus-infected Girl with Brain and Oesophageal Involvement.

Kasiri, K.A. and Rostampour, N. and Khoshdel, A. (2015) Case Presentation of a 23-Month-old Herpes Simplex Virus-infected Girl with Brain and Oesophageal Involvement. Journal of clinical and diagnostic research : JCDR, 9 (5). SD03-4. ISSN 2249-782X

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Abstract

Herpes simplex virus (HSV) is the most common identifiable cause of serious or life threatening sporadic, endemic encephalitis. Typical HSV encephalitis in patients outside neonatal age is caused by HSV-1. A 23-month-old girl was referred to our hospital with a three-day history of fever, listlessness, slurred speech, and suspicious oesophageal foreign body impaction. Laboratory evaluations showed white blood cell count of 10900 /mm3 with 65% neutrophils. Upper endoscopy revealed diffuse severe ulceration in middle to distal third of oesophagus and no foreign body was found in oesophagus or stomach. Parenteral acyclovir was prescribed for herpes encephalitis in addition to antibiotics for central nervous system infection. Chest X-ray and brain MRI was unremarkable. Lumbar puncture revealed normal protein and glucose with 10 white cell count. She developed a raising liver enzyme tests. Total and direct bilirubin was 1.2 mg/dc and 0.2 mg/dc respectively. Because of neurological symptoms, acyclovir was adopted for our patient from the beginning. The girl did not respond to medication and died after 28 days. Progression of her disease prior to referral appears to contribute to the administered treatment inefficacy. Severe rapid progression of disease prior to referral and potential resistance to acyclovir could cause treatment failure.

Item Type: Article
Uncontrolled Keywords: Acyclovir; Encephalopathy; Herpes simplex
Subjects: WC Communicable Diseases
WL Nervous system
Divisions: Faculty of Medicine > Department of Clinical Sciences > Department of Pediatrics
Depositing User: Users 1 not found.
Date Deposited: 25 Jul 2017 10:10
Last Modified: 25 Jul 2017 10:10
URI: http://eprints.skums.ac.ir/id/eprint/1750

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