PDF herunterladen
J Pediatr Infect Dis 2019; 14(01): 016-018
DOI: 10.1055/s-0037-1615274
Rapid Communication
Georg Thieme Verlag KG Stuttgart · New York

A Case Report of Fatal Necrotizing Encephalitis and Acute HBV Infection: Coincidence or Comorbidity?

Andrzej Krzysztofiak
1   Pediatric and Infectious Diseases Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
,
Elena Bozzola
1   Pediatric and Infectious Diseases Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
,
Cristina Russo
2   Virology Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
,
Rita De Vito
3   Pathology Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
,
Valerio Nobili
4   Hepato-Metabolic Diseases Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
,
Alberto Villani
1   Pediatric and Infectious Diseases Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
› Institutsangaben
Weitere Informationen

Publikationsverlauf

21. Dezember 2016

05. November 2017

Publikationsdatum:
29. Dezember 2017 (online)

Auch verfügbar auf
    Lizenzen und Reprints

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.

Keywords

encephalitis - hepatitis B virus - children

Funding

None.


 

  • References

  • 1 Weingarten L, Enarson P, Klassen T. Encephalitis. Pediatr Emerg Care 2013; 29 (02) 235-241 ; quiz 242–244
    CrossrefPubMedSuche in Google Scholar
  • 2 Thompson C, Kneen R, Riordan A, Kelly D, Pollard AJ. Encephalitis in children. Arch Dis Child 2012; 97 (02) 150-161
    CrossrefPubMedSuche in Google Scholar
  • 3 Wilson MR. Emerging viral infections. Curr Opin Neurol 2013; 26 (03) 301-306
    CrossrefPubMedSuche in Google Scholar
  • 4 Tong SP, Li JS, Vitvitski L, Trépo C. Active hepatitis B virus replication in the presence of anti-HBe is associated with viral variants containing an inactive pre-C region. Virology 1990; 176 (02) 596-603
    CrossrefPubMedSuche in Google Scholar
  • 5 Erhardt A, Blondin D, Hauck K. , et al. Response to interferon alfa is hepatitis B virus genotype dependent: genotype A is more sensitive to interferon than genotype D. Gut 2005; 54 (07) 1009-1013
    CrossrefPubMedSuche in Google Scholar
  • 6 Basaras M, Arrese E, Blanco S, Arroyo LS, Ruiz P, Cisterna R. Comparison of INNO-LIPA and TRUGENE assays for genotyping and drug-resistance mutations in chronic hepatitis B virus infection. Intervirology 2013; 56 (03) 190-194
    CrossrefPubMedSuche in Google Scholar
  • 7 Chattopadhyay S, Das BC, Hussain Z, Kar P. Hepatitis B virus genotypes in acute and fulminant hepatitis patients from north India using two different molecular genotyping approaches. Hepatol Res 2006; 35 (02) 79-82
    CrossrefPubMedSuche in Google Scholar