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Lead encephalopathy mimicking as acute encephalitis syndrome in a child

Savi Setia1, Ramandeep Singh2, Roshwanth A1

  • 1Pediatrics, All India Institute of Medical Sciences Bathinda, Bathinda, Punjab, India.

BMJ Case Reports
|July 1, 2026
PubMed

Insights

Lead encephalopathy, a severe neurotoxic emergency in children, can mimic infections. Early diagnosis and chelation therapy are crucial for preventing irreversible damage and potential fatality from lead poisoning.

Area of Science:

  • Pediatric Neurology
  • Environmental Toxicology
  • Neurotoxicology

Background:

  • Lead encephalopathy is a rare, life-threatening neurotoxic emergency in children.
  • It can be misdiagnosed as infectious encephalitis, delaying critical treatment, especially in resource-limited areas.

Purpose of the Study:

  • To highlight the importance of considering lead toxicity in pediatric encephalopathy cases.
  • To emphasize early diagnosis and intervention in suspected lead poisoning.

Main Methods:

  • Case report of a toddler presenting with symptoms mimicking infectious encephalitis.
  • Inclusion of patient history revealing environmental exposure (battery recycling unit).
  • Measurement of blood lead levels (BLL) and administration of chelation therapy.

Main Results:

  • The toddler presented with vomiting, fever, seizures, and neurological deterioration.
  • Blood lead levels (BLL) were significantly elevated at 88.1 mcg/dL.
  • Despite chelation therapy with dimercaprol and calcium disodium EDTA, the child experienced brain herniation and demised.

Conclusions:

  • Unexplained pediatric encephalopathy, particularly with environmental/occupational risk factors, warrants early consideration of lead toxicity.
  • Prompt, targeted history taking and timely chelation therapy are vital to prevent severe outcomes.
  • This case underscores the critical need for awareness and swift management of lead encephalopathy in children.

Keywords:
Coma and raised intracranial pressureExposuresToxicology

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