ABSTRACT
Herpes simplex encephalitis (HSE) is a leading cause of sporadic, nonepidemic viral encephalitis in children and adults. We report a very rare case of HSE with involvement of bilateral thalamus, putamen, upper pons and midbrain, with development of extrapyramidal symptoms which responded to corticosteroid therapy. A 15-mth-old female baby admitted with complaint of fever for 5 days and generalised tonic clonic seizure 10 hours before admission. On clinical examination patient was drowsy, temperature was 39.4 oC and vitals were stable with signs of increased intracranial tension. There were no signs of meningeal irritation. Patient gradually become unconscious in the next few hours and pupils were constricted bilaterally with development of atonia in all four limbs and neck muscles. Doll’s eye phenomenon was absent.
Subject(s)
Anti-Bacterial Agents/therapeutic use , Antiviral Agents/therapeutic use , Basal Ganglia Diseases/diagnosis , Basal Ganglia Diseases/drug therapy , Basal Ganglia Diseases/etiology , Drug Therapy, Combination , Electroencephalography , Encephalitis, Herpes Simplex/complications , Encephalitis, Herpes Simplex/diagnosis , Encephalitis, Herpes Simplex/drug therapy , Female , Fever/diagnosis , Fever/etiology , Follow-Up Studies , Humans , Infant , Magnetic Resonance Imaging , Mannitol/therapeutic use , Phenytoin/therapeutic use , Risk Assessment , Seizures/diagnosis , Seizures/etiology , Severity of Illness Index , Treatment OutcomeABSTRACT
Out of 6586 live born babies, 736 babies with jaundice were studied from 1st July 1996 to 30th June, 1997, in a city based medical college nursery. Physiological jaundice was present in 8.92% of all live born babies and accounted for 79.89% of babies with jaundice. Breast milk jaundice and prematurity were next common causes responsible for 5.29% each of all cases with neonatal jaundice. Septicaemia caused jaundice in 4.75% cases. Among the babies with jaundice appearing between day 4 and day 7 of life, breast milk jaundice was the commonest cause occurring in 49.25% cases. The last entity surfaced probably due to exclusive breastfeeding recently initiated in the baby friendly hospital nursery.