A Case of Acute Viral Encephalitis: Important Aspects and Related Literature Review of Sri Lankan Studies

H. T. D. W. Ariyarathna

doi:10.4038/mljsl.v8i2.7422

Abstract

Encephalitis in otherwise healthy and normal children causes many untimely deaths, giving rise to unexpected complications for physicians, forensic pathologists, and parents alike. Instead of resorting to extensive diagnostic options, aetiology can be identified in only around half of such cases. The case under discussion is a diagnosed case of viral encephalitis and the author attempts to discuss the multiple aspects surrounding the case. The victim was a previously healthy 9-year-old girl who presented with a three-day history of fever, vomiting, and altered consciousness with an episode of convulsion. No causative organism was identified while she was being treated. The histology revealed typical features of viral encephalitis along with other complications. The parental negligence could have been a contributory factor for her demise. Despite high fever with altered consciousness and convulsion, it had taken two days to diagnose her for having encephalitis upon admission. The forensic pathologist was inquired about the cause of her illness many times by the grieving parents. The parental grief was extensive in this case and the establishment of centres to deal with such encounters is suggested.

Highlights

It is necessary for a patient to present with features of alteration of consciousness or personality changes to continue for more than 24 hours, the onset of fever, and compatible features observed through imaging techniques or by EEG changes in order to be diagnosed as having encephalitis.[1]The effects of encephalitis may range from minor flu-like symptoms to permanent neurological damage and even death
The paper discusses the following aspects: the common causes of viral hepatitis based on limited literature, a possible causative agent of this case, delay in diagnosis and, the intense grief reaction of the parents
The only virus that had been studied to some extent until recently was the Japanese encephalitis virus (JEV) and it had been identified in some endemic areas: in the Western coastal belt up to the Northern Province

Summary

Introduction

It is necessary for a patient to present with features of alteration of consciousness or personality changes to continue for more than 24 hours, the onset of fever, and compatible features observed through imaging techniques or by EEG changes in order to be diagnosed as having encephalitis.[1]. Herpes simplex encephalitis (even with a recognized drug) The parents of this victim were extremely difficult to be convinced that encephalitis is at times a deadly disease in spite of being provided [2] with multiple explanations at multiple occasions. Their grief reaction was so intense that they themselves were clinically depressed. Hanta virus and Japanese encephalitis (JE) were tested negative. Blood culture was positive for coagulase-negative Staphylococcus species and Acinetobacter species.

Findings

Discussion

Conclusions