Key Words: encephalitis, coronavirus infections, COVID-19, child, pediatrics, perú
Abstract
There are limited reports of neurological symptoms in the pediatric population with COVID-19. We report a 13-year-old girl with three days of illness characterized by headache, non-explosive vomiting, fever, and sudden-onset sensory disorder associated with difficulty in standing and hemiparesis in limbs without evidence of meningeal signs. Brain tomography revealed diffuse brain edema, and the cerebrospinal fluid study was consistent with a viral infection. COVID-19 was diagnosed based on serology. The patient had an untoward clinical course despite treatment with hydroxychloroquine, azithromycin, and corticosteroids, dying on the third day of hospitalization. Encephalitis in a patient with COVID-19 is not frequently reported in the pediatric population. It should be considered in the differential diagnosis in patients who arrives at the emergency with a sensory disorder or neurological symptomatology in the context of the COVID-19 pandemic.
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Existen limitados reportes de síntomas neurológicos en la población pediátrica con COVID-19. Reportamos el caso de una niña de 13 años con tres días de enfermedad caracterizada por cefalea, vómitos no explosivos, fiebre y trastorno del sensorio de inicio brusco asociado a dificultad para la bipedestación y hemiparesia en extremidades, sin evidencia de signos meníngeos. La tomografía cerebral reveló edema cerebral difuso y el estudio de líquido cefalorraquídeo era concordante con una infección viral. El diagnóstico de COVID-19 fue mediante pruebas serológicas. La paciente tuvo una evolución clínica desfavorable a pesar del tratamiento con hidroxicloroquina, azitromicina y corticoides, falleciendo al tercer día de hospitalización. La encefalitis en un paciente con COVID-19 es una asociación poco descrita en la población pediátrica. Esta infección debe ser considerado como diagnóstico diferencial en los pacientes que llegan a la emergencia con trastorno de sensorio o sintomatología neurológica en el contexto de la actual pandemia.
Authors:
Nadin Melina Conto-Palomino[1], María Luz Cabrera-Bueno[1], Kenneth Grenis Vargas-Ponce [2], Evelina Andrea Rondón-Abuhadba [3], Noé Atamari-Anahui [4]
Affiliation:
[1] Servicio de Pediatría, Hospital Nacional Arzobispo Loayza, Lima, Perú
[2] Servicio de Neumología, Hospital Nacional Dos de Mayo, Lima, Perú
[3] Escuela Profesional de Medicina Humana, Facultad de Ciencias de la Salud, Universidad Nacional de San Antonio Abad del Cusco, Cusco, Perú
[4] Universidad San Ignacio de Loyola, Vicerrectorado de Investigación, Unidad de Investigación para la Generación y Síntesis de Evidencias en Salud, Lima, Perú
E-mail: noe.atamari@gmail.com
Author address:
[1] Avenida La Fontana 550, La Molina Lima, Perú
Citation: Conto-Palomino NM, Cabrera-Bueno ML, Vargas-Ponce KG, Rondón-Abuhadba EA, Atamari-Anahui N. Encephalitis associated with COVID-19 in a 13-year-old girl: A case report. Medwave 2020;20(7):e7985 doi: 10.5867/medwave.2020.07.7984
Submission date: 30/4/2020
Acceptance date: 30/6/2020
Publication date: 3/8/2020
Origin: Not commissioned
Type of review: Externally peer-reviewed by five reviewers, double-blind
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