OBJECTIVE: To outline a series of cases demonstrating neurologic complications in children with Influenza infection. The ongoing 2009 influenza A (H1N1) presents significant challenges to the field of pediatric critical care and requires increased awareness of new presentations and sequelae of infection. Since World Health Organization declared a H1N1 pandemic, much attention has been focused on its respiratory manifestations of the illness, but limited information regarding neurologic complications has been reported. DESIGN: Case series. SETTING: Pediatric intensive care unit of a tertiary care medical facility. PATIENTS: Four children admitted to the pediatric intensive care unit between March and November 2009 at the Children's Hospital of Pittsburgh with altered mental status and influenza infection. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: The clinical course was extracted by chart review and is summarized. All children demonstrated a coryzal prodrome, fever, and altered level of consciousness at admission, and one child presented with clinical seizures. Diagnostic studies performed to establish a diagnosis are summarized. All children had abnormal electroencephalograms early in their intensive care unit course and 50% had abnormal imaging studies. All children survived but 50% had neurologic deficits at hospital discharge. CONCLUSION: We conclude that 2009 influenza A (H1N1) can cause significant acute and residual neurologic sequelae. Clinicians should consider Influenza within a comprehensive differential diagnosis in children with unexplained mental status changes during periods of pandemic influenza.
OBJECTIVE: To outline a series of cases demonstrating neurologic complications in children with Influenza infection. The ongoing 2009 influenza A (H1N1) presents significant challenges to the field of pediatric critical care and requires increased awareness of new presentations and sequelae of infection. Since World Health Organization declared a H1N1 pandemic, much attention has been focused on its respiratory manifestations of the illness, but limited information regarding neurologic complications has been reported. DESIGN: Case series. SETTING: Pediatric intensive care unit of a tertiary care medical facility. PATIENTS: Four children admitted to the pediatric intensive care unit between March and November 2009 at the Children's Hospital of Pittsburgh with altered mental status and influenza infection. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: The clinical course was extracted by chart review and is summarized. All children demonstrated a coryzal prodrome, fever, and altered level of consciousness at admission, and one child presented with clinical seizures. Diagnostic studies performed to establish a diagnosis are summarized. All children had abnormal electroencephalograms early in their intensive care unit course and 50% had abnormal imaging studies. All children survived but 50% had neurologic deficits at hospital discharge. CONCLUSION: We conclude that 2009 influenza A (H1N1) can cause significant acute and residual neurologic sequelae. Clinicians should consider Influenza within a comprehensive differential diagnosis in children with unexplained mental status changes during periods of pandemic influenza.
Authors: Adrienne G Randolph; Frances Vaughn; Ryan Sullivan; Lewis Rubinson; B Taylor Thompson; Grace Yoon; Elizabeth Smoot; Todd W Rice; Laura L Loftis; Mark Helfaer; Allan Doctor; Matthew Paden; Heidi Flori; Christopher Babbitt; Ana Lia Graciano; Rainer Gedeit; Ronald C Sanders; John S Giuliano; Jerry Zimmerman; Timothy M Uyeki Journal: Pediatrics Date: 2011-11-07 Impact factor: 7.124
Authors: Gulam Khandaker; Yvonne Zurynski; Jim Buttery; Helen Marshall; Peter C Richmond; Russell C Dale; Jenny Royle; Michael Gold; Tom Snelling; Bruce Whitehead; Cheryl Jones; Leon Heron; Mary McCaskill; Kristine Macartney; Elizabeth J Elliott; Robert Booy Journal: Neurology Date: 2012-09-19 Impact factor: 9.910
Authors: Asha Prerna; Jocelyn Y X Lim; Natalie W H Tan; Mas Suhaila Isa; Helen May-Lin Oh; Norazieda Yassin; Chian-Yong Low; Derrick W S Chan; Chia-Yin Chong; Yee-Sin Leo; Angela Li-Ping Chow; Paul Ananth Tambyah; Kevin Tan Journal: J Neurovirol Date: 2015-04-28 Impact factor: 2.643