Polyarteritis nodosa with central nervous system involvement mimicking meningoencephalitis.

Abstract

OBJECTIVE:

To describe a patient who had polyarteritis nodosa with central nervous system involvement mimicking infectious meningoencephalitis.

DESIGN:

Case report.

SETTING:

Pediatric intensive care unit of a university hospital.

PATIENT:

A 9-yr-old boy with prolonged fever, headache, decreased level of consciousness, neck stiffness, and papilledema.

RESULTS:

Cerebrospinal fluid examination showed pleocytosis and a high protein level. After neurologic deterioration resulted from the initial treatment with antibiotic, the combination of clinical and laboratory findings with neuroradiologic features led to suspected systemic vasculitis. The patient was treated subsequently with corticosteroid, which resulted in great improvement. Biopsy of a skin lesion confirmed the diagnosis of polyarteritis nodosa.

CONCLUSIONS:

Critical care physicians must recognize neurologic manifestation patterns of systemic vasculitides because appropriate diagnosis and therapy result in significantly improved morbidity and mortality.

• Authors: Ana Paula De Carvalho Panzeri Carlotti, Virgínia Paes Leme Ferriani, Carla Tanuri Caldas, Maria Célia Cervi, Gecilmara Pileggi, Cássia Carvalho, Antônio Carlos Dos Santos, Daniel Chang
• Journal: Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies (Pediatr Crit Care Med) Vol. 5 Issue 3 Pg. 286-8 (May 2004) ISSN: 1529-7535 [Print] United States
• PMID: 15115570 (Publication Type: Case Reports, Journal Article)

Topics

• Central Nervous System Diseases (etiology, therapy)
• Child
• Diagnosis, Differential
• Humans
• Male
• Meningoencephalitis (diagnosis)
• Polyarteritis Nodosa (complications, diagnosis, therapy)