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J Pediatr Infect Dis 2014; 09(01): 037-041
DOI: 10.3233/JPI-140414
Case Report
Georg Thieme Verlag KG Stuttgart – New York

Acute disseminated encephalomyelitis in a child with chikungunya virus infection

Suman Das
a   Department of Pediatrics, BC Roy Post Graduate Institute of Pediatric Sciences, Kolkata, India
,
Nirmalya Sarkar
b   Department of Pediatrics, Apollo Gleangles Hospital, Kolkata, India
,
Jayitri Majumder
c   Department of Pediatrics, Calcutta National Medical College, Kolkata, India
,
Kaushani Chatterjee
d   Department of Pediatrics, Calcutta Medical College, Kolkata, India
,
Bholanath Aich
e   Department of Pediatrics, Behrampore Medical College, Kolkata, India
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Publikationsverlauf

11. August 2013

28. November 2013

Publikationsdatum:
28. Juli 2015 (online)

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Abstract

An 8-year-old boy was admitted to the Pediatric ward with high fever and severe arthritis of 4 days duration. Chikungunya virus serology was positive. As he became afebrile one week after admission, he developed acute onset right sided hemiparesis and suffered from one episode of generalized tonic clonic seizure. The next day he developed flaccid quadriplegia, loss of all sensory modalities below the C5 dermatome and urinary retention. After 4 weeks of shock stage, spasticity appeared in all 4 limbs. Magnetic resonance imaging (MRI) brain and spine showed extensive areas of demyelination-suggestive of acute disseminated encephalomyelitis (ADEM). He was treated with intravenous methyl prednisolone for 5 days, followed by oral prednisolone for 6 weeks. He was left with gross neurodeficits, including confinement to a wheel chair, persistent sensory loss and need for bladder catheterization.

Keywords

Chikungunya - ADEM - methyl prednisolone