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Journal of the Korean Child Neurology Society 2013;21(3):170-175.
Published online September 30, 2013.
A Case of Japanese Encephalitis Presenting with Fever and Seizure in a 7-month old Infant.
Soo Yeon Kim, Jon Soo Kim, Hyun Ju Lee, Hunmin Kim, Byung Chan Lim, Hee Hwang, Jong Hee Chae, Jieun Choi, Ki Joong Kim, Yong Seung Hwang
1Pediatric Clinical Neuroscience Center, Department of Pediatrics, Seoul National University Children's Hospital, Seoul, Korea.
2Department of Pediatrics, Seoul National University Bundang Hospital, Gyeonggi-do, Korea. hunminkim@hanmail.net
3Depeartment of Pediatrics, Seoul National University College of Medicine, Seoul, Korea.
4Department of Pediatrics, SMG-SNU Boramae Medical Center, Seoul, Korea.
Abstract
Japanese encephalitis is one of the leading causes of acute encephalitis in Asia. But in Korea, the number of Japanese encephalitis cases has dropped considerably due to mass vaccination and vector control. Especially, there were no case reports under the age of 9 years during the last ten years. We will describe a case of a previously healthy 7-month old boy who presented with fever and seizure. The patient was diagnosed with Japanese encephalitis, based on the cerebrospinal fluid and serum antibody analyses for the Japanese encephalitis virus. Typical brain magnetic resonance image findings of Japanese encephalitis were observed. The patient received extensive conservative treatment including high dose intravenous corticosteroid treatment and immunoglobulin. In spite of severe hemodynamic instability, the patient survived, and he is currently in a vegetative state with respiratory assist by a home ventilator. Although the incidence of Japanese encephalitis dropped dramatically in Korea, pediatricians should always consider the diagnosis as one of the possibilities for patients with encephalitis, especially if the patient is not immunized for JEV. Since there is no specific treatment for JEV, timely and comprehensive conservative care is critical to reduce the mortality and morbidity.
Key Words: Japanese encephalitis, pediatric, corticosteroid, immunoglobulin


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