Question of the Week

Question :
Posted On : 29 Oct 2023
A two and half year old girl was admitted with fever, vomiting, and convulsion. She was admitted and managed on the line of encephalitis. after 6-8 hours after treatment, her consciousness level improved by evening she even asked for food, and she was kept NPO for the night and treatment continued, but in the night she suddenly collapsed and was found dead by sister. What could be a possible cause of sudden death? Her plantar was extensor at the time of admission. Her CSF was not done as fundus could not be done in the morning and the patient was not stable and by evening she became conscious. What could be the cause of sudden death?
5
Expert Answer :
Rule out an arrhythmia, sudden intracranial raised ict, and electrolyte imbalance. An autopsy would give some clues.
Answer Discussion :
A
abbas Almamri
Profile
Brain herniation
7 months ago
M
Mohammed Abdul Rahman
Profile
Possibility of arrhythmias
7 months ago
M
muthu chidambaram
Profile
autonomic imbalance
7 months ago
D
Daniel Nkandela
Profile
hypoglycemia
7 months ago
L
lusungu muchelenganga
Profile
Her history is sad.
Well I have a few differentials on my list.
1.Uncal Herniation from cerebral edema causing cardio respiratory arrest and sudden death.
2.But possibility of intracranial hemorrhage cannot be ruled out due to the fact that she gained consciousness and then plummeted.
3.A possible Arrhythmia is possible because cerebral infections or pathological processes are associated with SIADH in which hyponatremia and several other electrolyte imbalances could cause Arrhythmias.
4.Neurohypoglycemia is also a possibility,it is not unusual to have hypoglycorrhacia in many CNS infections
5.We cannot rule out Drug poisoning especially salicylates can cause neurohypoglycemia.
6.We cannot rule out non accidental head trauma.

7 months ago




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