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Acute encephalopathy with biphasic seizures and late reduced diffusion associated with Streptococcus sanguinis sepsis

Hitoshi Awaguni, Jun Shinozuka, Shin-ichiro Tanaka, Sayaka Kadowaki, Shigeru Makino, Rikken Maruyama, Yosuke Shigematsu, Kenji Hamaoka, Shinsaku Imashuku
  • Hitoshi Awaguni
    Division of Pediatrics, Uji-Tokushukai Medical Center, Uji, Kyoto, Japan
  • Jun Shinozuka
    Division of Pediatrics, Uji-Tokushukai Medical Center, Uji, Kyoto, Japan
  • Shin-ichiro Tanaka
    Division of Pediatrics, Uji-Tokushukai Medical Center, Uji, Kyoto, Japan
  • Sayaka Kadowaki
    Division of Pediatrics, Uji-Tokushukai Medical Center, Uji, Kyoto, Japan
  • Shigeru Makino
    Division of Pediatrics, Uji-Tokushukai Medical Center, Uji, Kyoto, Japan
  • Rikken Maruyama
    Division of Pediatrics, Uji-Tokushukai Medical Center, Uji, Kyoto, Japan
  • Yosuke Shigematsu
    Division of Pediatrics, Uji-Tokushukai Medical Center, Uji, Kyoto, Japan
  • Kenji Hamaoka
    Division of Pediatrics, Uji-Tokushukai Medical Center, Uji, Kyoto, Japan

Abstract

Acute encephalopathy with biphasic seizures and late reduced diffusion (AESD) develops in association with systemic as well as central nervous system (CNS) viral or bacterial infections. AESD is most often noted with influenza or human herpesvirus 6 infection in previously healthy infants. However, AESD has also been reported in an infant with developmental retardation and in a mentally and motor-disabled adolescent. Here, we report the case of a 4-year-old female with significant development delay due to spinal muscular atrophy, who developed AESD during Streptococcus sanguinis sepsis with no apparent CNS infection. Although the patient had extremely high serum procalcitonin (45.84 ng/mL, reference; <0.4) on admission indicating a poor prognosis, she was successfully managed for sepsis and AESD.

Keywords

Acute encephalopathy with biphasic seizures and reduced diffusion, AESD, spinal muscular atrophy, Streptococcus sanguinis, sepsis

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Submitted: 2017-09-27 02:09:59
Published: 2018-03-29 15:40:55
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Copyright (c) 2018 Shinsaku Imashuku, Hitoshi Awaguni, Jun Shinozuka, Shin-ichiro Tanaka, Sayaka Kadowaki, Shigeru Makino, Rikken Maruyama, Yosuke Shigematsu, Kenji Hamaoka

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