Case 184

 An eight-year-old boy was sent to our hospital for conscious disorder by ambulance from a local hospital. Yesterday, he was diagnosed influenza A virus infection and administered Inavir. High fever decreased 37-38℃ from 39℃ at onset. He could barely drink fluids. Each time he drank water, he vomited it. From this afternoon, he grew dim and became delayed and dull to respond to calling from others. He gazed at the roof and fingered it with two hands. Several seconds later, his consciousness returned. The occurrence of becoming blurred repeated and its incidence increased. Then, he presented in our hospital. He had a spectrum disorder of autism. His body temperature was 37℃. In our hospital, it continued sometimes that while he became blurred and gazed at one point, he could not respond to calling. There was an episode that his lower and upper extremities grew rigid and his eye balls moved upward for several seconds after crying when her mother came to his room. He underwent brain MRI.

What is your diagnosis ?

1.　Acute hemorrhagic encephalitis

2.　Acute necrotizing encephalopathy

3.　Mild encephalitis with a reversible splenium lesion

4.　Posterior reversible encephalopathy syndrome

5.　Meningoencephalitis

answer

2020.3.18