Kernicterus: a case study

Abstract

Case Report: In our poster we would like to introduce a 4-day-old infant to you, who was due to an increasing icterus, feeding intolerance, weight reduction, and tiredness admitted to our hospital ward. The boy was delivered on time at home, the APGAR was 8/9/9 and the weight amounted to 3600 g at birth. In the admission situation to hospital he was presented in a weak general condition, hypotonic, and somnolent. A laboratory value of 36.2 mg/dL for bilirubin was found. Due to recurrent bradycardia and apnea, which showed several hours after admission, he was transferred to the intensive care unit, where the child was intubated because of respiratory breakdown and ventilated with a respirator. At the same time a phototherapy was started and immunoglobulin was administered. In the laboratory further increased grades of inflammation and pathological clotting results showed so that an antibiotic therapy was initiated and Konakion was administered. With the help of a liquor puncture meningitis was ruled out. In the further course of disease a reduction of the laboratory value for bilirubin and a stabilization of vital signs were recorded. However, the child became neurologically conspicuous on the day after admission. He showed a tendency to overstretch and an increased muscle tone of the upper extremities. Due to a burst-suppression-pattern in the EEG an antiepileptic therapy with Levetiracetam was indicated. The kernicterus was finally verified in the MRT of the cerebrum. A week after admission to hospital it was possible for the extubation to take place and to transfer the child to a normal ward after a few days.