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[Two cases of hemorrhagic shock and encephalopathy syndrome]
Insights
Two infants presented with fever, diarrhea, and seizures, exhibiting symptoms similar to hemorrhagic shock and encephalopathy (HSE). Rotavirus was detected in one case, suggesting a potential link for further investigation.
Area of Science:
- Pediatric Neurology
- Infectious Diseases
- Critical Care Medicine
Background:
- Hemorrhagic Shock and Encephalopathy (HSE) is a rare but severe condition in infants.
- The etiology of HSE remains largely unknown, posing diagnostic and therapeutic challenges.
Observation:
- Two male infants presented with severe symptoms including fever, watery diarrhea, unconsciousness, limb rigidity, and convulsions.
- Laboratory findings revealed elevated liver enzymes (GOT, GPT), decreased platelets and antithrombin III, increased Fibrin Degradation Products (FDP), and metabolic acidosis.
- Brain CT scans showed extensive low-density areas, particularly in the basal ganglia and brainstem in one case.
Findings:
- Rotavirus was identified in the stool of one infant, raising questions about its role in the observed clinical presentation.
- The clinical and radiological findings in both cases closely mimicked the characteristics of Hemorrhagic Shock and Encephalopathy (HSE).
Implications:
- These cases highlight a potential association between rotavirus infection and HSE-like illness in infants.
- Further research is crucial to elucidate the exact relationship between rotavirus and the pathogenesis of this severe neurological condition.
- The poor prognosis associated with this illness underscores the need for early recognition and management strategies.
Abstract:
A 10-month-old male infant (case 1) and another male infant aged 1 year and 11 months (case 2) were admitted to our department because of fever, watery diarrhea and convulsion. On admission, they were unconscious and showed rigidity of the limbs. Laboratory examination revealed a marked increase in GOT and GPT, a decrease in platelet and antithrombin III and an increase in FDP. Metabolic acidosis was found by blood gas analysis. Brain CT showed an extensive area of low density in case 1, and low density centering on the cerebral basal ganglia and brainstem in case 2. Rotavirus was detected in case 2 by fecal examination. The clinical pictures in these cases closely resembled those of hemorrhagic shock and encephalopathy (HSE) reported by Levin et al. in 1983. The etiology of this disease is currently unknown, and its prognosis is poor. The relationship between this disease and rotavirus should be examined in future studies.