Young Child Miraculously Defeats Life-Threatening Brain Infection and Organ Failure
PUNE: A five-year-old boy who suffered severe complications from a chikungunya infection, including brain encephalitis and multi-organ failure, was discharged from Sahyadri Hospitals MomStory this week, marking a significant triumph in pediatric medical care.
The child was initially seen by Dr Vinod Shelar, a Pediatrician at Chandan Nagar on August 18, due to a high fever but he started getting fits hence was urgently transferred to Sahyadri Hospitals MomStory Nagar Road – PICU, for specialized care.
“On arrival at MomStory, he had persistent convulsions and signs of severe brain infection including unequal pupils indicative of increased intracranial pressure. We noted the child’s condition required immediate intervention with ventilator support due to his unstable breathing and ongoing seizures, Continuous EEG monitoring also showed ongoing continuous convulsions that needed aggressive management to control it. This entity is called Non-Convulsive Status Epilepticus where convulsions are not seen but in the brain, there are ongoing convulsions. Hence he was started on continuous infusion of medicine to control ongoing seizures and raised brain pressure. Slowly EEG started to normalize. This if not treated urgently can cause severe brain dysfunction,” said Dr. Sagar Lad, Senior Pediatric Intensivist at Sahyadri Hospitals MomStory.
“The initial outlook was concerning as further tests showed acute liver failure which is seen in less than 3% of patients with chikungunya infection and needs urgent medication for liver regeneration and very low platelet and white blood cell counts, making treatment more complex. He received blood and platelet transfusions. He also had low blood pressure and refractory shock required medicines to normalize Blood pressure. A real-time PCR test soon confirmed a severe chikungunya infection. The situation worsened when he developed hemophagocytic lymphohistiocytosis, a rare and dangerous condition where the body’s immune system starts to damage its organs. These complications require strong treatment plans, including Intravenous Immunoglobulin and steroids, to effectively control the immune system’s excessive response,” explained Dr. Sagar Lad.
Dr. Pradeep Suryawanshi, Director of Neonatology & Paediatrics at Sahyadri Hospitals MomStory, stated, “During his stay, the child underwent continuous monitoring and multiple treatment adjustments to address the complex interplay of the infection and its broad impacts on his brain and other organs. The brain scans revealed widespread signs of encephalitis, a severe and uncommon condition in chikungunya cases.”
“After a tough but successful 14-day stay in the hospital with 2 weeks of ventilation the child made incredible progress and no longer needed the ventilator. His thinking and movement skills are almost back to normal, despite the severity of his case. He is now interacting well with the world around him,” said Dr. Suryawanshi.
On September 1, the child was discharged from the hospital. His condition had stabilized significantly, and he was able to return home with no ongoing neurological deficits.
“The family thanked the doctors and hospital staff deeply for their dedication and care, which transformed a critical situation into a story of survival and hope,” said Dr Prateek Kataria, senior consultant at the hospital.
The concerted efforts of a multidisciplinary team include Dr. Prateek Kataria, Dr. Preeti Lad, Dr. Sushmita Nimagadda, Dr Nikita Mankar, Dr Aaishwarya Dalal, Dr. Pranjali Fulari, Dr. Neha Kunturkar, and Dr. Dinesh Thakre, with critical support from pediatric liver specialist Dr. Snehvardhan Pandey and pediatric hematologist Dr. Kannan.
“Chikungunya is considered to be not a very serious infection in children but in this current situation in Pune, we are seeing very complicated chikungunya infection, especially in children affecting the brain causing convulsion, decreasing level of consciousness, and even coma. If not detected early can be life-threatening. Probably this is due to a change in the Virulence factor of the virus,” said Dr Sagar Lad.
