[Encephalopathy associated with severe bacterial infections: "presuppurative encephalitis" or "toxi-infectious disorder"?].
Three children are reported, exhibiting encephalopathic symptoms in the course of a severe bacterial infection, though they had no sign of intracranial purulent collection nor metabolic disturbances: the first was associated with a appendicular peritonitis, the second with a purulent knee arthritis, the third with a pneumoccus septicemia. The elements are reviewed that favor either a true septic encephalitis, i.e. microscopic presuppurative foci, versus a toxiinfectious process, either by direct action of toxins or through intracerebral activation of pre-inflammatory cytokines. Whatever the mechanism involved in individual cases, the treatment is mainly based on prompt administration of the convenient antibiotics.
Thi
V A Pham
VA
Service de Neurologie pédiatrique, CHU Paris sud-Bicêtre, AP-HP, Hôpital de Bicêtre, 94270 Le Kremlin Bicêtre.
Nordmann
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P
Landrieu
P
P
D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001170:Arthritis, Infectious / Q000150:complications / Q000188:drug therapy / Q000523:psychology; D001424:Bacterial Infections / Q000150:complications* / Q000188:drug therapy / Q000523:psychology; D001921:Brain / Q000473:pathology; D001927:Brain Diseases / Q000188:drug therapy / Q000209:etiology* / Q000523:psychology; D002675:Child, Preschool; D016207:Cytokines / Q000096:biosynthesis; D004569:Electroencephalography; D004731:Endotoxins / Q000633:toxicity; D015658:HIV Infections / Q000150:complications; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D010538:Peritonitis / Q000150:complications / Q000188:drug therapy / Q000523:psychology; D011008:Pneumococcal Infections / Q000150:complications / Q000188:drug therapy / Q000523:psychology; D018805:Sepsis / Q000150:complications / Q000188:drug therapy / Q000523:psychology
D000900:Anti-Bacterial Agents; D016207:Cytokines; D004731:Endotoxins