Hypoglycaemic Encephalopathy following Coronavirus Disease in a Six-month-old Infant: A Rare Case Report

Abstract

Hypoglycaemia refers to a state when the blood sugar level drops below the normal range of 70-110 mg/dL. Blood sugar level, or glucose in the blood, is responsible for various vital functions. A decrease in blood glucose levels causes a wide range of clinical presentations, from tremors to coma and even death. Long-term hypoglycaemia can lead to extensive neuronal damage due to apoptosis and energy failure. Additionally, authors discuss a rare case of a six-month-old male neonate who presented with fever, diarrhoea, and two episodes of convulsions over the last two days. The movements started with an ictal cry and were followed by micturition and defecation. Nasal and throat swabs were positive for SARS-CoV-2 viral antigen. A plane Magnetic Resonance Imaging (MRI) of the brain was performed, which revealed evidence of altered signal intensity in the cortical and subcortical areas of the right frontal-temporal-parietal-occipital region, suggesting hypoglycaemic encephalopathy. The patient was given a breastfeeding trial and managed with 25% dextrose initially at a rate of 0.2 g/kg for 48 hours, as the patient was symptomatic, followed by an infusion of dextrose normal saline. After ruling out all possibilities of hypoglycaemic encephalopathy, the diagnosis of hypoglycaemic encephalopathy secondary to Coronavirus Disease (COVID-19) was made.

Keywords

• apoptosis
• neuronal damage
• paediatric
• radiology
• viral antigen