Influenza A in children complicated by encephalitis - case study

Abstract

Influenza is a seasonal disease that can cause annual outbreaks, especially during the cold periods of the year, in temperate areas. Symptomatology mainly involves the upper and lower respiratory tract, but varies greatly depending on the age and medical history of each person. In this paper we present a clinical case of influenza type A complicated with encephalitis in a female child aged 5 years and 6 months with a personal pathological history of neurological damage (Guillain-Barre syndrome). The diagnosis of influenza was established on the basis of symptoms (productive cough, rhinorrhea, marked physical asthenia, high fever) and confirmed by laboratory tests (rapid influenza antigen test and influenza RT PCR from nasopharyngeal secretions - positive). Neurological involvement was clinically supported by the occurrence of bradykinesia, bradypsy, broad-based gait, confirmed by neurological examination. The diagnosis of encephalitis was completed by analysis of cerebrospinal fluid (CSF) obtained by lumbar puncture in which influenza virus type A was identified and by electroencephalogram (EEG) showing altered tracing. Under antiviral (Oseltamivir), pathogenic (corticosteroid therapy), brain depleting (mannitol solution), non-specific human and symptomatic immunoglobulins treatments, the evolution was slowly favorable with remission of symptoms. The case presented argues that although influenza in immunocompetent children is generally a self-limiting and uncomplicated condition, it can evolve severely with the development of complications and after-effects and sometimes increased mortality especially in immunocompromised hosts.

Keywords

• influenza type a
• encephalitis
• child