title: Influenza-related postinfectious encephalomyelitis complicated by a perforated peptic ulcer.
abstract: Influenza virus infection is extremely common and raises global concern due to the increasing prevalence of pandemic H1N1 infection. Influenza may occasionally be associated with neurologic complications and, also, rarely with gastrointestinal complications. Here, we report a rare case complicated with appendicitis, duodenum perforation, and transient delirious behavior after influenza A viral infection in a pediatric patient aged 14 years. The transient delirious behavior could be attributed to postinfectious encephalopathy. The perforated peptic ulcer could have resulted from influenza infection, could have been an adverse event related to oseltamivir administration, or could have been a complication of preceding gastroenteritis. Our case highlights the importance of pediatric healthcare workers to be aware of possible complications arising from both influenza infection and oseltamivir therapy, even though some of these complications may be relatively rare.
authors.affiliation: Department of Pediatrics, Landseed Hospital, Taoyuan, Taiwan.
authors.forename: Chang-Wei
authors.initials: CW
authors.lastname: Hsueh
authors.forename: Hui-Ming
authors.initials: HM
authors.lastname: Yu
authors.forename: Huan-Sheng
authors.initials: HS
authors.lastname: Chen
authors.forename: Chin-Pyng
authors.initials: CP
authors.lastname: Wu
mesh_terms: D000293:Adolescent; D003131:Combined Modality Therapy; D004673:Encephalomyelitis, Acute Disseminated / Q000209:etiology / Q000503:physiopathology / Q000628:therapy / Q000821:virology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053118:Influenza A Virus, H1N1 Subtype / Q000472:pathogenicity*; D007251:Influenza, Human / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D008279:Magnetic Resonance Imaging / Q000379:methods; D053139:Oseltamivir / Q000009:adverse effects* / Q000627:therapeutic use; D010439:Peptic Ulcer Perforation / Q000209:etiology* / Q000503:physiopathology / Q000628:therapy; D018570:Risk Assessment; D012720:Severity of Illness Index; D016896:Treatment Outcome
chemical_list: D053139:Oseltamivir
keywords: acute disseminated encephalomyelitis; influenza A infection; oseltamivir; perforated peptic ulcer