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Neurogenic pulmonary edema following febrile status epilepticus in a 22-month-old infant with multiple respiratory

Yoshie Takagi1,2, Takeaki Imamura2,3, Shota Endo1

  • 1Department of Pediatrics, Showa General Hospital, 8-1-1 Hanakoganei, Kodaira, Tokyo, 187-8510, Japan.

BMC Infectious Diseases
|June 4, 2020
PubMed

Insights

Neurogenic pulmonary edema can complicate febrile status epilepticus in children. Prompt seizure control and respiratory support led to a full recovery in a young patient, though viral links remain unclear.

Area of Science:

  • Pediatric Neurology
  • Critical Care Medicine
  • Infectious Diseases

Background:

  • Neurogenic pulmonary edema (NPE) is a rare but severe complication of febrile status epilepticus (FSE) in children.
  • Viral pathogen screening is often overlooked in the initial assessment of febrile illnesses in pediatric patients.

Observation:

  • A 22-month-old girl experienced her first FSE episode, subsequently developing acute pulmonary edema and respiratory failure.
  • The patient required intubation and mechanical ventilation in the emergency room following seizure termination.
  • Complete resolution of respiratory failure and neurological recovery occurred within 9 hours of admission.

Findings:

  • Molecular diagnostics identified human coronavirus HKU1, influenza C virus, and human parainfluenza virus 2 in nasopharyngeal specimens.
  • The patient was discharged 6 days post-admission with no residual complications.
  • The identified viruses' specific roles in the clinical presentation are currently speculative.

Implications:

  • This case highlights the potential for NPE following FSE in children.
  • Early seizure termination and aggressive respiratory management are crucial for favorable outcomes.
  • Further research is needed to elucidate the association between specific respiratory viruses and NPE in pediatric FSE.
Abstract

Keywords:
Co-detectionFebrile status epilepticusHuman coronavirus HKU1Human parainfluenza virus 2Influenza C virusMultiplex real-time RT-PCRNeurogenic pulmonary edema

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