A Case Report of Fatal Necrotizing Encephalitis and Acute HBV Infection

Coincidence or Comorbidity?

Research output: Contribution to journalArticle

Abstract

We report the first fatal pediatric case of encephalitis associated with hepatitis B virus (HBV) infection. A Caucasian, previously healthy, and vaccinated 7-year-old girl was evaluated at our hospital for fever, vomiting, tremors, and loss of consciousness. At admission, she underwent brain computed tomographic scan, electroencephalogram, lumbar puncture, and blood examination. In 12 hours, her clinical condition deteriorated and the patient entered coma and died. A laboratory error was useful to reach a predeath diagnosis, showing HBV-DNA on blood. Autopsy confirmed HBV-PCR DNA in brain, lymphnodes, lungs, liver, and spleen. We generally do not search HBV-DNA in organic fluid of Italian children with encephalitis, as they are currently all vaccinated. Consequently, as a teaching lesson, we would suggest not to take anything obvious.

Original languageEnglish
Pages (from-to)16-18
Number of pages3
JournalJournal of Pediatric Infectious Diseases
Volume14
Issue number1
DOIs
Publication statusPublished - Jan 1 2019

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Acute Hemorrhagic Leukoencephalitis
Virus Diseases
Hepatitis B virus
Comorbidity
Encephalitis
DNA
Spinal Puncture
Unconsciousness
Brain
Tremor
Coma
Vomiting
Electroencephalography
Autopsy
Teaching
Fever
Spleen
Pediatrics
Polymerase Chain Reaction
Lung

Keywords

  • children
  • encephalitis
  • hepatitis B virus

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Infectious Diseases

Cite this

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title = "A Case Report of Fatal Necrotizing Encephalitis and Acute HBV Infection: Coincidence or Comorbidity?",
abstract = "We report the first fatal pediatric case of encephalitis associated with hepatitis B virus (HBV) infection. A Caucasian, previously healthy, and vaccinated 7-year-old girl was evaluated at our hospital for fever, vomiting, tremors, and loss of consciousness. At admission, she underwent brain computed tomographic scan, electroencephalogram, lumbar puncture, and blood examination. In 12 hours, her clinical condition deteriorated and the patient entered coma and died. A laboratory error was useful to reach a predeath diagnosis, showing HBV-DNA on blood. Autopsy confirmed HBV-PCR DNA in brain, lymphnodes, lungs, liver, and spleen. We generally do not search HBV-DNA in organic fluid of Italian children with encephalitis, as they are currently all vaccinated. Consequently, as a teaching lesson, we would suggest not to take anything obvious.",
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AU - Krzysztofiak, Andrzej

AU - Bozzola, Elena

AU - Russo, Cristina

AU - De Vito, Rita

AU - Nobili, Valerio

AU - Villani, Alberto

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N2 - We report the first fatal pediatric case of encephalitis associated with hepatitis B virus (HBV) infection. A Caucasian, previously healthy, and vaccinated 7-year-old girl was evaluated at our hospital for fever, vomiting, tremors, and loss of consciousness. At admission, she underwent brain computed tomographic scan, electroencephalogram, lumbar puncture, and blood examination. In 12 hours, her clinical condition deteriorated and the patient entered coma and died. A laboratory error was useful to reach a predeath diagnosis, showing HBV-DNA on blood. Autopsy confirmed HBV-PCR DNA in brain, lymphnodes, lungs, liver, and spleen. We generally do not search HBV-DNA in organic fluid of Italian children with encephalitis, as they are currently all vaccinated. Consequently, as a teaching lesson, we would suggest not to take anything obvious.

AB - We report the first fatal pediatric case of encephalitis associated with hepatitis B virus (HBV) infection. A Caucasian, previously healthy, and vaccinated 7-year-old girl was evaluated at our hospital for fever, vomiting, tremors, and loss of consciousness. At admission, she underwent brain computed tomographic scan, electroencephalogram, lumbar puncture, and blood examination. In 12 hours, her clinical condition deteriorated and the patient entered coma and died. A laboratory error was useful to reach a predeath diagnosis, showing HBV-DNA on blood. Autopsy confirmed HBV-PCR DNA in brain, lymphnodes, lungs, liver, and spleen. We generally do not search HBV-DNA in organic fluid of Italian children with encephalitis, as they are currently all vaccinated. Consequently, as a teaching lesson, we would suggest not to take anything obvious.

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