Hemorrhagic shock and encephalopathy. Clinical definition of a catastrophic syndrome in infants

We treated nine infants who unexpectedly developed shock, seizures, and fever, followed by diarrhea, consumption coagulopathy, and hepatorenal dysfunction. Despite vigorous treatment, three infants died and all except one of the six survivors have severe residual neurologic abnormalities. Postmortem...

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Bibliographic Details
Published inAmerican journal of diseases of children (1960) Vol. 144; no. 10; p. 1079
Main Authors Chaves-Carballo, E, Montes, J E, Nelson, W B, Chrenka, B A
Format Journal Article
LanguageEnglish
Published United States 01.10.1990
Subjects
Brain Diseases - diagnosis
Brain Diseases - pathology
Brain Diseases - therapy
Diagnosis, Differential
Female
Hemolytic-Uremic Syndrome - diagnosis
Humans
Infant
Infant, Newborn
Male
Reye Syndrome - diagnosis
Shock, Hemorrhagic - diagnosis
Shock, Hemorrhagic - pathology
Shock, Hemorrhagic - therapy
Shock, Septic - diagnosis
Syndrome
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Summary:We treated nine infants who unexpectedly developed shock, seizures, and fever, followed by diarrhea, consumption coagulopathy, and hepatorenal dysfunction. Despite vigorous treatment, three infants died and all except one of the six survivors have severe residual neurologic abnormalities. Postmortem findings included cerebral edema, white matter petechial hemorrhages, gastrointestinal hemorrhages, and fatty liver. These clinicopathologic features are similar to those previously described in 10 infants as being due to hemorrhagic shock and encephalopathy, except for the presence of fatty liver in our patients. Based on the combined experience of 19 infants, we propose diagnostic criteria for hemorrhagic shock and encephalopathy that may facilitate recognition and differentiation from other shock syndromes in infancy.
ISSN:0002-922X
DOI:10.1001/archpedi.1990.02150340023017