A 2-year-old boy with hemolytic uremic syndrome and pneumocephalus

Sarah E. Martin, Steven D. Allen, Phillip Faught, Dean A. Hawley, Jose Bonnin, Eyas M. Hattab

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Clostridium septicum infection following hemolytic uremic syndrome is rare and carries a poor prognosis, especially when the brain is involved. We report a case of a previously healthy 2-yearold boy who presented with two days of anuria and bloody diarrhea. He was admitted to the local children's hospital with a diagnosis of hemolytic uremic syndrome, presumably secondary to E. coli O157. He soon required intubation and was noted to have fixed and dilated pupils. Head CT revealed left frontal subcortical white matter vasogenic edema and scattered pockets of pneumocephalus. The patient expired 14 hours after admission. Antemortem blood cultures grew C. septicum. Gross pathologic examination of the brain revealed a large intraparenchymal cerebral hemorrhage in the left frontal and parietal lobes. There was extensive cystic changes as well. Microscopic examination revealed vacuolization and diffuse colonization with rod-shaped bacteria, but without the expected tissue response. There have been only six previously reported cases of C. septicum infection following hemolytic uremic syndrome, four of which had brain involvement. Mortality rate is high, with the only known survivor among those with brain involvement having a brain abscess rather than diffuse pneumocephalus.

Original languageEnglish
Pages (from-to)121-124
Number of pages4
JournalBrain Pathology
Volume22
Issue number1
DOIs
StatePublished - Jan 2012

Fingerprint

Pneumocephalus
Hemolytic-Uremic Syndrome
Clostridium septicum
Clostridium Infections
Brain
Pupil Disorders
Anuria
Parietal Lobe
Brain Abscess
Escherichia coli O157
Cerebral Hemorrhage
Frontal Lobe
Intubation
Survivors
Diarrhea
Edema
Head
Bacteria
Mortality

ASJC Scopus subject areas

  • Neuroscience(all)
  • Pathology and Forensic Medicine
  • Clinical Neurology

Cite this

Martin, S. E., Allen, S. D., Faught, P., Hawley, D. A., Bonnin, J., & Hattab, E. M. (2012). A 2-year-old boy with hemolytic uremic syndrome and pneumocephalus. Brain Pathology, 22(1), 121-124. https://doi.org/10.1111/j.1750-3639.2011.00555.x

A 2-year-old boy with hemolytic uremic syndrome and pneumocephalus. / Martin, Sarah E.; Allen, Steven D.; Faught, Phillip; Hawley, Dean A.; Bonnin, Jose; Hattab, Eyas M.

In: Brain Pathology, Vol. 22, No. 1, 01.2012, p. 121-124.

Research output: Contribution to journalArticle

Martin, SE, Allen, SD, Faught, P, Hawley, DA, Bonnin, J & Hattab, EM 2012, 'A 2-year-old boy with hemolytic uremic syndrome and pneumocephalus', Brain Pathology, vol. 22, no. 1, pp. 121-124. https://doi.org/10.1111/j.1750-3639.2011.00555.x
Martin, Sarah E. ; Allen, Steven D. ; Faught, Phillip ; Hawley, Dean A. ; Bonnin, Jose ; Hattab, Eyas M. / A 2-year-old boy with hemolytic uremic syndrome and pneumocephalus. In: Brain Pathology. 2012 ; Vol. 22, No. 1. pp. 121-124.
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