The common cold has caused a lifetime of debilitating health issues for this UK toddler
Key Takeaways
Industry Insights
"It can be temporary, it can be mild, it can be severe. It can have long, lasting consequences." — Dean Blumberg, MD
“This child and her parents are now facing a long struggle, and they will need a great deal of support and physical and other therapies to help this child achieve whatever she can as she grows older.” — William Schaffner, MD
“That's part of the challenge of being a physician, to not miss something that's very, very rare like that. I think that haunts a lot of physicians in that they see common colds, commonly, [but] there's that one patient [with] a more severe complication. That's just a challenge of clinical practice." — Dean Blumberg, MD
Find more of your peers' perspectives and insights below.
A 3-year-old girl in the UK has experienced brain damage after contracting a cold virus.[]
What began as a virus likened to the common cold escalated to encephalitis, causing brain injury and dystonia.[]
“It's not common, but any of the common cold viruses, including influenza, enteroviruses, rhinoviruses, even adenovirus… all of them can result in an aberrant immune reaction to the virus that can sometimes result in encephalitis. It can be temporary, it can be mild, it can be severe. It can have long, lasting consequences,” Dean Blumberg, MD, Chief of Pediatric Infectious Diseases at UC Davis Health, tells MDLinx.
“Any time you hear of these cases, they're so scary, obviously, so scary for the child, for the parents and for the whole family, and they're tragic, but fortunately, they are rare. They're a very rare complication of common infections,” Dr. Blumberg adds.
The child in the UK spent 12 weeks at a rehabilitation facility after being discharged from hospital, but her parents have been told she may never walk or talk again.[]
“This child and her parents are now facing a long struggle, and they will need a great deal of support and physical and other therapies to help this child achieve whatever she can as she grows older, given that she has some permanent disability,” William Schaffner, MD, an expert in infectious diseases at Vanderbilt University, tells MDLinx.
Prevalence in the US
In the United States, cases of infectious encephalitis are most commonly caused by enteroviruses, herpes simplex types 1 and 2, and arboviruses like West Nile.[]
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Vaccination against other viruses has assisted in reducing rates.
“Some of the more common causes of encephalitis of yesteryear have now been prevented through vaccination. Measles, mumps, and chicken pox, since we routinely use those vaccines in children, these more common in the past causes of encephalitis have been virtually eliminated,” Dr. Schaffner says.
While some people experiencing encephalitis may not present with any symptoms, others may have mild flu-like symptoms including fever, headache, fatigue, and body aches.[]
For this reason, Dr. Blumberg says it can sometimes be difficult to distinguish encephalitis from a typical viral infection. “That's part of the challenge of being a physician, to not miss something that's very, very rare, like that. And I think that haunts a lot of physicians in that they see common colds, commonly—they'll see 100 or 1,000 patients with common colds who are going to get better—and then there's that one patient that they don't want to miss that might have a more severe complication. That's just a challenge of clinical practice,” he says.
Here's what happened
The UK child was initially sent home from the hospital with antibiotics. After returning to hospital by ambulance as her condition deteriorated, she was diagnosed with encephalitis following a CT scan.[]
Both Dr. Blumberg and Dr. Schaffner say a thorough evaluation is crucial when diagnosing encephalitis.
“Do a good and thorough evaluation of the patient when first seen. High fever and, remember, altered mental status are absolutely critical. When in doubt, admit the patient and do further diagnostic testing,” Dr. Schaffner says.
Encephalitis can be particularly dangerous in infants,[] but distinguishing between encephalitis and other common viruses among the pediatric population can present some challenges for physicians.
“Especially in children, if they are ill with any kind of viral or bacterial infection, they may not be thinking or behaving normally—they may be lethargic, they may be less responsive—and all of those can be signs of encephalopathy or encephalitis. But they may also just be a child who's sick with a fever and doesn't feel well, and that can be very difficult to sort out,” Dr. Blumberg said.