title: Unusual encephalopathy after acute chest syndrome in sickle cell disease: acute necrotizing encephalitis.
abstract: Stroke is the most common neurologic complication of sickle cell disease. Acute chest syndrome (ACS) is a known risk factor for stroke in this population. Two patients (a 12-year-old boy and a 6-year-old girl) developed acute change of mental status and focal neurologic signs during episodes of ACS. The clinical and radiologic findings were compatible with acute necrotizing encephalitis, a variant of acute demyelinating encephalomyelitis. Patients with acute neurologic deterioration in conjunction with ACS should be evaluated thoroughly for other causes of central nervous system disease including infectious/parainfectious processes as well as stroke.
mesh_terms: D000212:Acyclovir / Q000627:therapeutic use; D000755:Anemia, Sickle Cell / Q000150:complications*; D001921:Brain / Q000473:pathology; D002648:Child; D004318:Doxycycline / Q000627:therapeutic use; D004679:Encephalomyelitis / Q000150:complications* / Q000188:drug therapy; D017707:Erythrocyte Transfusion; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D011019:Pneumonia, Mycoplasma / Q000150:complications; D013577:Syndrome; D014057:Tomography, X-Ray Computed; D014640:Vancomycin / Q000627:therapeutic use
chemical_list: D014640:Vancomycin; D004318:Doxycycline; D000212:Acyclovir