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Hemorrhagic shock and encephalopathy syndrome: Report of two cases
Insights
Hemorrhagic shock and encephalopathy syndrome (HSES) is a severe condition in children, often presenting with fever and altered consciousness. Early recognition and management are critical due to rapid progression and high mortality rates.
Area of Science:
- Pediatrics
- Critical Care Medicine
- Infectious Diseases
Background:
- Hemorrhagic shock and encephalopathy syndrome (HSES) is a rare but severe pediatric condition.
- Prompt diagnosis and intervention are crucial for improving patient outcomes.
Observation:
- Two pediatric patients presented with diarrhea, high fever, and altered consciousness.
- Both patients exhibited disseminated intravascular coagulation, abnormal liver and kidney function, and metabolic acidosis.
- Clinical deterioration led to shock and death within 24 hours of admission.
Findings:
- Serum ammonia levels and blood/cerebrospinal fluid cultures were normal, ruling out certain metabolic and infectious causes.
- Diagnosis of HSES was established based on clinical presentation and laboratory findings.
- The syndrome's rapid progression and fatal outcome were noted in both cases.
Implications:
- This case highlights the critical need for heightened awareness of HSES among clinicians.
- Further research into the pathophysiology and treatment of HSES is warranted.
- Understanding HSES is vital for timely diagnosis and management in pediatric critical care settings.
Abstract:
Two young children with a history of diarrhea, for one and two days respectively, were admitted to our hospital due to high fever and conscious disturbance. Disseminated intravascular coagulation, abnormal hepatic and renal functions, and metabolic acidosis were noted as well. Both patients developed shock soon after arrival and expired within one day after admission. Their serum ammonia levels were normal, and their blood and cerebrospinal fluid cultures also brought negative results. Hemorrhagic shock and encephalopathy syndrome was diagnosed by their clinical manifestation and laboratory data. We also discussed their related problems.