حسین سلطان زاده
استاد دانشگاه علوم پزشکی شهید بهشتی
متخصص کودکان ونوزادان
طی دوره بالینی عفونی از میوکلینیک آمریکا
دبیر برگزاری کنفرانس های ماهیانه گروه اطفال
دانشگاه علوم پزشکی شهید بهشتی
معرفی : دکتر فریبا شیروانی
فوق تخصص عفونی اطفال
به اتفاق اعضای
هیئت علمی گروه کودکان
بیمارستان امام حسین
The patient is a
9-year old boy, native of and resident in Parsabad Moghan who was hospitalized
in this Center on June 24,2005 due to dizziness, feebleness and vomiting. The
problem started on May 12,2005 when he fainted and went dizzy on his way to
school. Consequently, he started vomiting and was taken to Parsabad Hospital. In
the hospital, he had repeated convulsions accompanied by fever. The convulsions
were GTC type gradually changing into status epilepticus. As his convulsions
could not be controlled and his conditions aggravated, the Patient was
transferred to Ardebil Hospital.
History: The Patient had a history of seizure in the form of GTC and Staring
since 2 years ago and had gone under treatment with Phenobarbital of 100mg/
daily dosage. He had later become D/C but his convulsions continued until the
time of hospitalization.
Parents are far
relatives and have two other healthy children.
In Ardebil, admitted
with clinical manifestation of headache, neck rodor, reduced consciousness level
and repeated convulsions and LP was carried out and reported as:
RBC = 600
WBC = 10
Prot = 165
glu = 26
Brain CT was taken
and reported non-communicated hydrocephaly.
His disease was
diagnosed as encephalitis 24 hours after hospitalization in Ardebil, the
convulsions was controlled with Phenobarbital. but the patient is then afflicted
to Lt. hemiplegia .
Four days after
discharge from the hospital, the patient is again afflicted with attacks of
vomiting, headache and dizziness and is referred to this Center (Mofid
Hospital). Upon entry to the Hospital, the patient was ill and febrile and in a
state of dizziness, feebleness and headache. He was unable to stand or walk and
had recurrent vomiting.
On examination: Hc=
52 Wt: 18 fundoscopy NL DTR +++, Plantar Reflexdown and Lt. hemiparesis.
Once again, LP was done for the patient, PCR Herpes Virus and CFS study in view
of tb along with Gastric Washing in view of BK was requested. Based on the
results of LP:
Glucose = 10
WBC = 256 →P %10,
CSF CULTURE = Neg
PCR HERPES: Neg
CBC: WBC = 5700
( POLY = 68 LYM = 29
Hb = 11 MCV = 77
PLT = 210000
SGOT=22 SGPT =31
What is the patient's possible diagnosis?