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Influenza Virus-Associated Acute Necrotizing Encephalopathy in Two Young Children: Case Report

Prisca Largo1, Olivia C Arnone2, Francesco Sacco1

  • 1Pediatric Intensive Care Unit, University Hospital of Verona, Piazzale Stefani 1, 37126 Verona, Italy.

Reports (MDPI)
|August 4, 2025
PubMed

Insights

Acute necrotizing encephalopathy (ANE) is a severe complication of influenza in children. Early recognition of neurological symptoms is crucial for timely treatment, though outcomes remain poor.

Area of Science:

  • Neurology
  • Pediatrics
  • Infectious Diseases

Background:

  • Acute necrotizing encephalopathy (ANE) is a rare but severe neurological complication primarily affecting children following influenza virus infections.
  • While often sporadic, familial and recurrent cases suggest potential genetic predispositions, such as RANBP2 mutations.

Observation:

  • Two young girls, one with a history of ANE, presented with severe neurological deterioration, including seizures and altered consciousness, following influenza A infection.
  • Cerebral MRI scans confirmed the diagnosis of ANE in both cases.
  • Despite aggressive treatment with corticosteroids and immunoglobulins, both patients had poor prognoses.

Findings:

  • Influenza virus A was identified as the trigger in both pediatric cases of ANE.
  • The study highlights the diagnostic utility of MRI in identifying ANE.
  • Aggressive treatment regimens did not prevent poor outcomes in these severe cases.

Implications:

  • Prompt identification of neurological symptoms during influenza-like illnesses is critical for initiating prompt therapy.
  • Further research is essential to elucidate the pathophysiology of ANE and develop effective treatment strategies.
  • ANE poses a significant threat to children, with high mortality and potential for long-term neurological deficits.

Keywords:
MRI cerebral scanacute necrotizing encephalopathyhigh-dose corticosteroidsinfluenza virus infection

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