4th Pediatric Infectious Diseases Conference
 
 
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Specialist Answers
Question
Dear sir 5 years old boy present to ED as fever+ prolonged febrile fit & treated as such. The next day was still febrile+ deep coma. No history of trauma , drugs or recent chicken pox was present. On examination nothing apart from fever + deep coma which persist for 10 days was observed. Investigation done included 1.normal CSF 2.cbc was also normal 3.widal test was megative 4.CXR is nomal &cat scan revealed mild brain atrophy 5.EEG global dysfuntion. The patient was treated as viral encephalitis[iv zovirax + cefitriaxone + steroid +mannitol + ng feeding] what else can be done for this poor patient.?
Answer
Since CSF is normal and other tests are also normal, the child seems to have encephopathy rather than encephalitis. There is slight brain atrophy on scan and one should rule out HIV infection. Also rule out Inborn errors such as Lactic acidosis, Glutaric acidemia, Fatty acid oxidation defects and Reye's syndrome. Do a venous blood gases, serum lactate and pyruvate, urine orgainc acids and amino acids and serum ammonia and sugar. An MRI of the brain will also be useful.
 
 
 
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