Polyarteritis nodosa with central nervous system involvement mimicking meningoencephalitis.
OBJECTIVE
To describe a patient who had polyarteritis nodosa with central nervous system involvement mimicking infectious meningoencephalitis.


METHODS
Case report.


METHODS
Pediatric intensive care unit of a university hospital.


METHODS
A 9-yr-old boy with prolonged fever, headache, decreased level of consciousness, neck stiffness, and papilledema.


RESULTS
Cerebrospinal fluid examination showed pleocytosis and a high protein level. After neurologic deterioration resulted from the initial treatment with antibiotic, the combination of clinical and laboratory findings with neuroradiologic features led to suspected systemic vasculitis. The patient was treated subsequently with corticosteroid, which resulted in great improvement. Biopsy of a skin lesion confirmed the diagnosis of polyarteritis nodosa.


CONCLUSIONS
Critical care physicians must recognize neurologic manifestation patterns of systemic vasculitides because appropriate diagnosis and therapy result in significantly improved morbidity and mortality.
Paula De Carvalho Panzeri Carlotti
Ana
A
Department of Pediatrics, Hospital das Clínicas, Faculty of Medicine of Ribeirão Preto, University of São Paulo, Brazil. carlotti@fmrp.usp.br
Paes Leme Ferriani
Virgínia
V
Tanuri Caldas
Carla
C
Célia Cervi
Maria
M
Pileggi
Gecilmara
G
Carvalho
Cássia
C
Carlos Dos Santos
Antônio
A
Chang
Daniel
D
D002493:Central Nervous System Diseases / Q000209:etiology* / Q000628:therapy; D002648:Child; D003937:Diagnosis, Differential; D006801:Humans; D008297:Male; D008590:Meningoencephalitis / Q000175:diagnosis*; D010488:Polyarteritis Nodosa / Q000150:complications / Q000175:diagnosis* / Q000628:therapy