952 Encephalitis Due Influenza A (H1N1) in a Seven Year-Old Girl with Good Response to Oseltamivir

Abstract

Background and Aims Human infection with the novel H1N1 influenza virus was first reported in April 2009. Novel Influenza A (H1N1) virus produces higher mortality in young people. Different clinical manifestation of Influenza A (H1N1) has been reported. We present encephalitis due influenza A (H1N1) with good response to oseltamivir. Patient The patient was a seven year-old girl presented with mood change and gait ataxia from 5 days before admission. She also had fever, delusion, and lethargy. She had history of common cold several days before admission. She was treated with acyclovir with impression of encephalitis without improvement. In physical examination (P/E) she was febrile, there was no nuchal rigidity. P/E of chest, abdomen and extremities were normal. Lumbar puncture was performed. Cerebrospinal fluid (CSF) was normal. CSF culture showed no growth after 48h. CBC, FBS, BUN, Cr, Na, K, ALT, AST, CRP and procalcitonin were all normal. HSV PCR was negative. Elecroencephalography (EEG) was performed that suggested encephalitis. Brain MRI was normal. Throat culture was obtained for the diagnosis of influenza A (H1N1) that was positive. The patient was treated with oseltamivir. The patient recovered after treatment and tests for equilibrium became normal. Conclusions Encephalitis due to influenza A (H1N1) should be considered in every patient with signs and symptoms of encephalitis during influenza A (H1N1) pandemy.