case of herpes simplex encephalitis with unusual presentation

History and investigation are the leader in helping physicians to reach a proper diagnosis; this aim is applied in both simple and complicated cases such as Herpes Simplex Encephalitis [HSE]. USE can be consider as life threatening condition due to its high mortality rate in delayed treated condition and neurological sequelae even if treatment initiated early. This was applied on a four years old girl presented to us with one day history of head trauma which was supported by hemorrhage seen in CT-Head, 72 hours later her condition deteriorate by recurrent convulsions, aphasia, change level of consciousness and spikes of fever, diagnosis of USE was delayed till day 10 of presentation when she start to have frequent attacks of convulsions, which was proved by positive CSF PCR for HSV

Kawasaki disease in Kuwaiti family

Kawasaki disease [KD] is one of the most common vasculitis of childhood. We describe the occurrence of Kawasaki disease in five children belonging to the same family, within a period of four months. Between the months of October 2000 and January 2001, five Kuwaiti children, belonging to the same extended family, were diagnosed with Kawasaki disease. All children fulfilled at least four of the five additional criteria for the diagnosis of Kawasaki disease. They received intravenous immunoglobulins commencing within the first 24 hours of admission in addition to salicylates. The duration of fever ranged between one and eight days. Most patients reported to have marked irritability and one had signs of meningeal irritation. Another child had severe genital erythema and peeling which subsided one day after the initiation of treatment. The laboratory findings showed raised platelet count after the first week in most patients. All throat swab cultures yielded b-hemolytic Streptococcus group Aorganisms. However, the ASOT titer was not raised. They all received intravenous immunoglobulins and salicylates and made a good clinical recovery. One child had a relapse ten months later and developed dilatation of the left descending coronary artery but no aneurysm. The cause of Kawasaki disease remains unclear after thirty years of research. The results emphasize the possibility of both genetic predisposition and environmental factors in the etiology of Kawasaki disease