A Case of Acute Encephalopathy Associated with Acute Focal Bacterial Nephritis

Abstract

Acute encephalopathy is a syndrome characterized by an acute onset of disturbance of consciousness. Many acute encephalopathies are caused by viral infections; however, they can also be a result of bacterial infections. Acute focal bacterial nephritis (AFBN) can cause neurological symptoms, such as irritation, unconsciousness, and seizures. In some cases, AFBN-associated acute encephalopathy has also been reported. This report describes the first case of acute encephalopathy without the characteristic findings of MRI-associated AFBN. The patient was a 3-year-old male, who had febrile seizure at the ages of 1 and 2 years. He developed disturbance of consciousness, irritability, excitability, and neck stiffness on the day after admission. There were no abnormal findings on brain MRI; however, a generalized high-voltage slow wave was noted on electroencephalography (EEG). His urinary sediment count was elevated, and Morganella morganii and Enterococcus faecalis were detected in the urinary culture. A diagnosis of acute encephalopathy with urinary tract infection (UTI) was made.

Two Cases of Acute Focal Bacterial Nephritis With Central Nervous System Manifestations in Children and Literature Review

“…According to Japanese guidelines, acute encephalopathy can be classified based on pathogen detection or MRI. There are fewer reports of acute encephalopathy due to UTI or AFBN; 14,15 however, other diagnoses such as encephalitis/MERS, acute encephalopathy with bipolar and delayed diffusion reduction, and hyperammonemic encephalopathy have also been reported. 16 Our patient 2 underwent 2 MRI scans at different phases, and neither of them showed any MERS abnormalities.…”