Journal of Pediatric Infectious Diseases 2019; 14(01): 016-018
DOI: 10.1055/s-0037-1615274
Rapid Communication
Georg Thieme Verlag KG Stuttgart · New York

A Case Report of Fatal Necrotizing Encephalitis and Acute HBV Infection: Coincidence or Comorbidity?

Andrzej Krzysztofiak
1  Pediatric and Infectious Diseases Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
,
Elena Bozzola
1  Pediatric and Infectious Diseases Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
,
Cristina Russo
2  Virology Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
,
Rita De Vito
3  Pathology Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
,
Valerio Nobili
4  Hepato-Metabolic Diseases Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
,
Alberto Villani
1  Pediatric and Infectious Diseases Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
› Author Affiliations
Further Information

Publication History

21 December 2016

05 November 2017

Publication Date:
29 December 2017 (online)

Abstract

We report the first fatal pediatric case of encephalitis associated with hepatitis B virus (HBV) infection. A Caucasian, previously healthy, and vaccinated 7-year-old girl was evaluated at our hospital for fever, vomiting, tremors, and loss of consciousness. At admission, she underwent brain computed tomographic scan, electroencephalogram, lumbar puncture, and blood examination. In 12 hours, her clinical condition deteriorated and the patient entered coma and died. A laboratory error was useful to reach a predeath diagnosis, showing HBV–DNA on blood. Autopsy confirmed HBV–PCR DNA in brain, lymphnodes, lungs, liver, and spleen. We generally do not search HBV–DNA in organic fluid of Italian children with encephalitis, as they are currently all vaccinated. Consequently, as a teaching lesson, we would suggest not to take anything obvious.

Funding

None.