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CT, MRI Show Surprising Brain Changes in Child with H1N1 Flu

February 15, 2010
Written by: , Filed in: Pediatric Radiology
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In a rare case, a child has died from acute necrotizing encephalopathy (ANE) as a complication of H1N1 flu, say doctors in Corpus Christi, Texas. Radiologists reported the case in the February issue of Pediatric Radiology.

According to the World Health Organization, more than 209 countries worldwide have reported confirmed cases of H1N1 flu, including more than 14,000 deaths. Most of the children’s fatalities have been caused by pulmonary complications.

In this case, a 12-year-old girl was admitted to the Driscoll Children’s Hospital emergency room the day after she began showing symptoms, including high fever, profuse diarrhea, increased weakness, and general pain. Otherwise healthy, she had felt good and played soccer the night before she fell ill. She had not had vaccines for either seasonal or H1N1 flu.

Both a chest X-ray and CT scan taken after the child was admitted to the ER appeared normal. But 14 hours later, an MRI showed severe brain changes, including multifocal symmetrical lesions in the thalami, cerebellar hemispheres, brain stem, and cerebral white matter.  Severe brainstem edema developed along with progressive effacement of the basal cisterns, and the child was pronounced brain-dead three days later. Respiratory secretions confirmed H1N1 flu.

“We hope this case will alert radiologists to this complication and familiarize [them] with imaging findings that herald ANE,” the researchers wrote in the study abstract.

FREE report: Pediatric Radiology: Building an Effective Safety Team


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