క్లినికల్ పీడియాట్రిక్స్: ఓపెన్ యాక్సెస్
అందరికి ప్రవేశం

నైరూప్య

A Previously Healthy Infant with Decreased Feeding, Progressive Weakness, Unresponsiveness and Respiratory Failure: Is it the Brain to Blame?

Feyza Incekoy Girgin, Oznur Ozer, Cihan Senturk, Furkan Eser, Gülten Thomas, Eda Kepenekli Kadayifci, Makbule Nilufer Ozturk

A 3 and a half month old otherwise healthy girl born in the USA presented with insufficient nursing noticed by her mother at the sixth day of their vacation in Russia. She was fed with breast milk and supplemental formula only. In the following three days, oral intake and urinary output decreased gradually, and she was observed to have a low pitched cry and constipation. There was no fever. She was taken to a local hospital in Russia, where the physical examination revealed hypotonia, tachycardia, tachypnea and desaturation. Laboratory investigations including complete blood cell count, biochemistry, venous blood gas and peripheral blood smear analysis were normal. In the following hours, she developed muscle weakness in all extremities with unresponsiveness to painful stimuli. Horizontal nystagmus was noted and her pupils were bilaterally dilated with no light reflex. Acute meningoencephalitis was suspected with possible seizure activity and she was treated with corticosteroids, antibiotics, barbiturate and valproic acid.