ABSTRACT
Herpes simplex encephalitis (HSE) is a leading cause of sporadic, nonepidemic viral encephalitis in children and adults. We report a very rare case of HSE with involvement of bilateral thalamus, putamen, upper pons and midbrain, with development of extrapyramidal symptoms which responded to corticosteroid therapy. A 15-mth-old female baby admitted with complaint of fever for 5 days and generalised tonic clonic seizure 10 hours before admission. On clinical examination patient was drowsy, temperature was 39.4 oC and vitals were stable with signs of increased intracranial tension. There were no signs of meningeal irritation. Patient gradually become unconscious in the next few hours and pupils were constricted bilaterally with development of atonia in all four limbs and neck muscles. Doll’s eye phenomenon was absent.
Subject(s)
Anti-Bacterial Agents/therapeutic use , Antiviral Agents/therapeutic use , Basal Ganglia Diseases/diagnosis , Basal Ganglia Diseases/drug therapy , Basal Ganglia Diseases/etiology , Drug Therapy, Combination , Electroencephalography , Encephalitis, Herpes Simplex/complications , Encephalitis, Herpes Simplex/diagnosis , Encephalitis, Herpes Simplex/drug therapy , Female , Fever/diagnosis , Fever/etiology , Follow-Up Studies , Humans , Infant , Magnetic Resonance Imaging , Mannitol/therapeutic use , Phenytoin/therapeutic use , Risk Assessment , Seizures/diagnosis , Seizures/etiology , Severity of Illness Index , Treatment OutcomeABSTRACT
A newborn presented with erythematous lesion over face, which appeared soon after birth. Diagnosis of neonatal lupus erythematosus (NLE) was confirmed by positive anti-Ro SSA antibody and skin biopsy. But anti-La SSB antibody was negative. Her hepatic transaminases were high. But no cardiac manifestations were noted.