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Case Reports
. 2020 Jun 1;20(1):388.
doi: 10.1186/s12879-020-05115-2.

Neurogenic pulmonary edema following febrile status epilepticus in a 22-month-old infant with multiple respiratory virus co-detection: a case report

Yoshie Takagi  1   2 , Takeaki Imamura  2   3 , Shota Endo  1 , Kenta Hayashi  1 , Satoka Akiyama  1 , Yoji Ikuta  1 , Takahiro Kawaguchi  1 , Tomoko Sumita  1 , Tatsuo Katori  1 , Masanori Hashino  4 , Shinji Saito  5 , Takato Odagiri  5 , Kunihiro Oba  1 , Makoto Kuroda  4 , Tsutomu Kageyama  6
Affiliations
Case Reports

Neurogenic pulmonary edema following febrile status epilepticus in a 22-month-old infant with multiple respiratory virus co-detection: a case report

Yoshie Takagi et al. BMC Infect Dis. .

Abstract

Background: Neurogenic pulmonary edema is a rare but serious complication of febrile status epilepticus in children. Comprehensive screening for viral pathogens is seldomly performed in the work-up of febrile children.

Case presentation: A 22-month-old girl presented with her first episode of febrile status epilepticus, after which she developed acute pulmonary edema and respiratory failure. After the termination of seizure activity, the patient was intubated and managed on mechanical ventilation in the emergency room. The resolution of respiratory failure, as well as the neurological recovery, was achieved 9 h after admission, and the patient was discharged 6 days after admission without any complications. Molecular biological diagnostic methods identified the presence of human coronavirus HKU1, influenza C virus, and human parainfluenza virus 2 from the patient's nasopharyngeal specimens.

Conclusions: Neurogenic pulmonary edema following febrile status epilepticus was suspected to be the etiology of our patient's acute pulmonary edema and respiratory failure. Timely seizure termination and rapid airway and respiratory intervention resulted in favorable outcomes of the patient. Molecular biological diagnostic methods identified three respiratory viruses; however, their relevance and association with clinical symptoms remain speculative.

Keywords: Co-detection; Febrile status epilepticus; Human coronavirus HKU1; Human parainfluenza virus 2; Influenza C virus; Multiplex real-time RT-PCR; Neurogenic pulmonary edema.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Chest radiograph findings. a. Revealing bilateral, centrally distributed opacities, without cardiac dilation upon ER arrival. b. Remarkable improvement of lung consolidation can be observed on hospital day 2
See this image and copyright information in PMC

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