Subscribe to RSS
DOI: 10.1055/s-0037-1615274
A Case Report of Fatal Necrotizing Encephalitis and Acute HBV Infection: Coincidence or Comorbidity?
Publication History
21 December 2016
05 November 2017
Publication Date:
29 December 2017 (online)
![](https://www.thieme-connect.de/media/10.1055-s-00029028/201901/lookinside/thumbnails/10-1055-s-0037-1615274_1700098-1.jpg)
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.
Funding
None.
-
References
- 1 Weingarten L, Enarson P, Klassen T. Encephalitis. Pediatr Emerg Care 2013; 29 (02) 235-241 ; quiz 242–244
- 2 Thompson C, Kneen R, Riordan A, Kelly D, Pollard AJ. Encephalitis in children. Arch Dis Child 2012; 97 (02) 150-161
- 3 Wilson MR. Emerging viral infections. Curr Opin Neurol 2013; 26 (03) 301-306
- 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
- 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
- 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
- 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