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Case Report: A 4-year-old previously healthy male presented with headache, abdominal pain, unresponsiveness, left-sided weakness, and right eye deviation. Vital signs were T 37.1°C, BP 126/80, and HR 61. Exam… Click to show full abstract
Case Report: A 4-year-old previously healthy male presented with headache, abdominal pain, unresponsiveness, left-sided weakness, and right eye deviation. Vital signs were T 37.1°C, BP 126/80, and HR 61. Exam showed somnolence, rightward eye deviation, left-sided hyperreflexia, and a benign abdomen. Brain MRI demonstrated multi-focal ischemic infarcts and leptomeningeal enhancement. CSF revealed WBC 66 (52L/46N), protein 41, and glucose < 20. Ceftriaxone, vancomycin, and fluconazole were empirically started; blood, urine, and CSF cultures remained negative. MRA, echo, HIV, HSV, hypercoagulability labs, and autoimmune labs were unrevealing. Further history revealed patient had lived …
Journal Title: Pediatrics
Year Published: 2018
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