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[A case of acquired encephalopathy in a child. A cause that we thought had disappeared]

F Monpoux1, G Pitelet, C Richelme

  • 1Service de pédiatrie, hôpital de l'Archet II, 151, route de Saint-Antoine-de-Ginestière, 06202 Nice cedex 3, France. monpoux.f@chu-nice.fr

Archives De Pediatrie : Organe Officiel De La Societe Francaise De Pediatrie
|November 11, 2008
PubMed

Insights

Subacute central nervous system infections, like HIV encephalopathy, can cause progressive developmental delays in infants. Early diagnosis and antiretroviral treatment are crucial for improving neurological outcomes in affected children.

Area of Science:

  • Pediatrics
  • Neurology
  • Infectious Diseases

Background:

  • Subacute central nervous system (CNS) infections require consideration in infants with progressive encephalopathy.
  • Maternal HIV infection poses a risk for vertical transmission to the infant, potentially leading to neurological complications.

Observation:

  • An 18-month-old child presented with spastic hypertonia and axial hypotonia after normal early development.
  • The child's mother was diagnosed with HIV, and the infant tested positive for HIV with a decreased CD4 cell count and detectable viral load.
  • Brain MRI revealed white matter hypersignals, indicative of CNS involvement.

Findings:

  • The infant was diagnosed with HIV-related encephalopathy, presumed to be due to maternal-fetal transmission.
  • Antiretroviral therapy, including azidothymidine, lamivudine, and boosted lopinavir, was initiated.
  • Neurological symptoms showed improvement after two months of treatment.

Implications:

  • HIV infection should be suspected in infants presenting with progressive encephalopathy.
  • Routine HIV testing for pregnant women, including repeat testing in the third trimester, is recommended to prevent vertical transmission.
  • Timely diagnosis and initiation of antiretroviral therapy can significantly improve neurological outcomes in pediatric HIV encephalopathy.

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