Article in Japanese
A case of neurogenic pulmonary edema complicated with febrile seizures requiring differentiation from coronavirus disease 2019
Toshiki TAKEO1), Yoshihiko KAWANO1), Nobuyuki TETSUKA2), Shinya HARA1)
Neurogenic pulmonary edema (NPE) is pulmonary edema secondary to various central nervous system disorders, but there are few reports of NPE complicated with febrile seizures. A 2-year-old boy with a history of febrile seizures developed fever and tonic-clonic convulsion. Although the convulsion lasted for 50 minutes and stopped after intravenous administration of diazepam, he presented forced breathing and needed oxygen. Chest X-ray and computed tomography showed predominantly ground-glass opacities in the bilateral hilar centers. His respiratory status improved in a short period of about 10 hours with no oxygen needed, and his illness was therefore diagnosed as NPE. Since coronavirus disease 2019 (COVID-19) was prevalent, polymerase chain reaction (PCR) tested for SARS-CoV-2, but the result proved negative. After that, herpes simplex virus gingivostomatitis was diagnosed serologically. There was no recurrence of NPE. Infectious pneumonia accounts for a large proportion of pediatric lung diseases and respiratory disorders, and the differential diagnosis of noninfectious diseases, including NPE, may be delayed, especially during the COVID-19 pandemic. It is important to note changes in respiratory status after febrile seizures, especially in cases of status epilepticus, and recognize NPE at an early stage in cases of secondary respiratory disorders.
1) Department of pediatrics, Toyota Memorial Hospital
2) Department of central infection control, Nagoya University Hospital
Key words | child, neurogenic pulmonary edema, febrile seizures, coronavirus disease 2019 |
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Received | September 24, 2020 |
Accepted | March 10, 2021 |
33 (2):113─119,2021
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