[A child with sepsis-associated encephalopathy].

Area of Science:

• Neurology
• Pediatrics
• Infectious Diseases

Background:

• Sepsis-associated encephalopathy (SAE) is a critical neurological complication of systemic infection, primarily documented in adults.
• Pediatric cases of SAE are rare, making diagnosis and understanding challenging.

Observation:

• A 4-year-old girl presented with fever, vomiting, and neurological deficits including vigilance disorders, loss of verbal fluency, and cerebellar syndrome.
• Initial investigations for infectious encephalitis were negative; however, MRI revealed diffuse brain edema, and EEG showed global slowing.
• The underlying cause was identified as perforated appendicitis with peritonitis, treated successfully with surgery and antibiotics.

Findings:

• The diagnosis of sepsis-associated encephalopathy was confirmed after ruling out other potential causes.
• The patient experienced a full neurological recovery, with normal clinical examination, MRI, and EEG after one year of follow-up.
• This case adds to the limited published pediatric SAE literature, underscoring diagnostic criteria and favorable outcomes.

Implications:

• SAE diagnosis requires a severe infectious syndrome with neurological symptoms, excluding shock and other causes.
• MRI findings in SAE include non-specific diffuse lesions and vasogenic edema, while EEG typically shows diffuse slowing.
• While most patients recover, some may experience persistent neurological sequelae, necessitating further research into underlying mechanisms and targeted treatments.