Last week, City Children’s Hospital received a case of Tr. DA 7 years old, male, weight 38 kg, lives in Vinh Loc B, Binh Chanh. Taking the medical history, the child had a high fever continuously for 1 day, convulsions in the whole body, cyanosis, the family took the child to the City Children’s Hospital to continue.
Here, the child was lethargic, comatose, convulsed all over the body, received respiratory support to prevent convulsions, given antipyretic drugs, the child stopped convulsions but was lethargic, gradually comatose, was intubated to help Ventilation, mechanical ventilation, anti-brain edema with 20% mannitol and 3% sodium chloride. Blood tests showed that the child had an increase in Hct concentration, a decrease in platelets, a rapid test for NS1 antigen to diagnose dengue was positive, a CSF puncture showed biochemical results, and normal cells. Diagnosis of cerebral hemorrhagic fever. By day 4 of illness the child entered shock with a mild tachycardia, clamped blood pressure, intravenous anti-shock fluids, and invasive blood pressure and central venous pressure measurements to guide appropriate fluid administration and vasopressors.
Test results showed that the child had liver damage, coagulation disorders, metabolic acidosis, and hypoglycemia. Children are actively treated with mechanical ventilation, anti-shock fluids, anti-convulsants, anti-brain edema, liver support treatment such as adjusting blood sugar, electrolytes, and acid-base. After more than a week of treatment, the child’s condition improved gradually and was weaned from the ventilator.
This is a rare case of cerebral hemorrhagic fever in overweight children, which is easily misdiagnosed with other diseases, so parents should be careful.
After more than a week of treatment, the child’s condition improved gradually and was weaned from the ventilator.
Doctor of CKII Nguyen Minh Tien
City Children’s Hospital