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A severe neurological complication of influenza in a previously well child

Philippa McSwiney1, Jessica Purnama2, Andrew Kornberg3

  • 1Department of General Medicine, The Royal Children's Hospital, Melbourne, Victoria, Australia.

BMJ Case Reports
|October 25, 2014
PubMed

Insights

A rare case of acute necrotising encephalopathy (ANE) in a child caused by influenza A highlights the severe risks of this infection. Genetic factors, like the RANBP2 gene mutation, increase susceptibility, underscoring the need for flu vaccination.

Area of Science:

  • Neurology
  • Infectious Diseases
  • Genetics

Background:

  • Influenza A can lead to severe neurological complications in children.
  • Acute necrotising encephalopathy (ANE) is a rare but devastating consequence of influenza infection.
  • Genetic predispositions can increase the risk of developing ANE.

Observation:

  • A 3-year-old girl presented with encephalopathy and hemiparesis due to influenza A.
  • Brain MRI revealed extensive necrotic and hemorrhagic changes consistent with ANE.
  • Genetic testing identified a RANBP2 gene mutation, a known risk factor for ANE.

Findings:

  • The patient received prompt treatment with antivirals and corticosteroids.
  • Intensive rehabilitation led to a remarkable recovery.
  • The case confirms the link between influenza A, RANBP2 mutation, and ANE.

Implications:

  • Highlights ANE as a severe, albeit rare, complication of influenza in children.
  • Emphasizes the role of genetic factors, such as RANBP2 mutations, in ANE susceptibility.
  • Stresses the importance of pediatric influenza vaccination to prevent severe outcomes.

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