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Abstract Details

Acute Necrotizing Encephelitis Associated with Adenovirus Infection in a 5-Year Old Boy
Neurotoxicology
P06 - (-)
230
BACKGROUND: To improve our knowledge of necrotizing encephalitis pathogenesis.
DESIGN/METHODS: Case report.
RESULTS: We describe a 5 year old child who presented with rapid onset of altered mental status. This presentation was preceded by one week of fevers and gastrointestinal (GI) symptoms including abdominal pain, vomiting, and diarrhea. Physical exam demonstrated an obtunded male with conjunctivitis, increased tone, and symmetric 3+ deep tendon reflexes. Admission labs demonstrated a normal WBC with left shift, elevated C- reactive protein, and a mild transaminitis. Molecular studies included respiratory virus PCR positive for adenovirus. Lumbar puncture was unremarkable. MRI of the brain with and without contrast showed bilateral symmetrical lesions in the distribution involving the thalami, putamina, parasagittal occipital lobes and bilateral parietal lobes. Literature search yielded many cases in which such a symmetrical distribution on MRI imaging paired with both GI and sudden altered mental status indicating acute necrotizing encephalopathy (ANE). ANE is a devastating progressive neurological disease that has been reported to occur in healthy children after acute viral illnesses. This case is remarkable in that although approximately 110 cases of ANE have been reported in PubMed from 1965 until present, they have not yet been previously linked to an adenovirus infection.
CONCLUSIONS: This case is remarkable in that although approximately 110 cases of ANE have been reported in PubMed from 1965 until present, they have not yet been previously linked to an adenovirus infection.
Authors/Disclosures
Tammy Hennika, MD (Genentech, A Member of the Roche Group)
PRESENTER 		No disclosure on file
Jeffrey Cohen, MD, PhD, FAAN (SpecialtyCare) No disclosure on file
Hassanain Toma, MD (Royal Columbian Hospital) No disclosure on file
Murtaza Khan, MD (University of Kansas Hospital) Dr. Khan has nothing to disclose.
Arezou Heshmati, MD Dr. Heshmati has nothing to disclose.