Fever, headache then coma after 2 days
The Department of Pediatrics, Central Tropical Diseases Hospital is treating many pediatric patients with Japanese encephalitis, including cases admitted to the hospital when the disease was already in a severe stage.
Patient G.A.D, 9 years old, in Lao Cai, initially only had a fever and headache. After a day of using fever-reducing medicine, the child still had a continuous high fever, gradually increased headache, accompanied by vomiting and nausea. The family took the child to a district hospital for treatment, but only one day later, the child began to become slow, unable to speak, unable to eat and drink and gradually fell into a coma.
After being transferred to medical levels, the child was diagnosed with Japanese encephalitis and transferred to the National Hospital for Tropical Diseases in a state of coma, respiratory failure, and quadriplegia. Doctors had to actively resuscitate, anti-inflammatory, anti-cerebral edema and insert endotracheal tubes, supporting mechanical ventilation.
Dr. Le Thi Thu Hien, Department of Pediatrics, National Hospital for Tropical Diseases, said that after about two weeks of treatment, the patient's awareness has improved, the child is more alert, breathes on his own and successfully quits the ventilator. However, his physical strength is still weak, his ability to cough and expectorant is poor, and the risk of neurological sequelae such as epilepsy still exists. The child needs to continue to be monitored and rehabilitated.
Easy to confuse with common viral infections
According to Dr. Dang Thi Thuy, Head of Pediatrics Department, National Hospital for Tropical Diseases, Japanese encephalitis is an acute viral infection, affecting the central nervous system and transmitted through virus-carrying mosquitoes. The disease usually increases in the summer, when hot and humid weather creates conditions for mosquitoes to develop.
It is noteworthy that initial symptoms are often not specific. Children may only have high fever, headache, fatigue, poor appetite, so they are easily mistaken for common viral infections.
In older children, headaches are an easily recognizable symptom. In young children who do not know how to speak, the disease can manifest as abnormal fussiness, loss of appetite or poor eating.
After a few hours to a few days, the disease can progress with signs such as increased headache, frequent vomiting, changes in consciousness or behavior, convulsions, lethargy, difficulty waking up, lethargy and coma. Severe cases can be respiratory failure, circulatory failure, life-threatening.
Japanese encephalitis does not have specific treatments, mainly supportive treatment and intensive care. About 50% of surviving children may have neurological sequelae. Therefore, parents need to get fully vaccinated, prevent mosquito bites and take children to medical facilities immediately if there are abnormal signs such as fever, headache, lethargy, convulsions or weakness in limbs.
