PRIKAZ IZ PRIMARNE PEDIJATRIJSKE SLUŽBE - UDRUŽENOST VARICELLA-ZOSTER VIRUSNE INFEKCIJE I SINDROMA NEADEKVATNE SEKRECIJE ANTIDIURETSKOG HORMONA

Apstrakt

Introduction: Varicella has been a common reason for pediatric out-patient visit. Uncomplicated forms resolve without need for pediatric check-ups while new symptoms or complications after the acute phase demand a medical attention. Possible complications are the following: Varicella-zoster encephalitis and meningoencephalitis involving the spinal cord, cranial nerves, and basal ganglia.

Case report: We are presenting a case of a three-year-old boy brought by his parents to the Primary Care pediatrician, nine days after the Varicella onset, due to symptoms related to the central nervous system: vomiting, headache, lethargy, unsteady gait, and drowsiness. Given the boy’s clinical features, he was referred to a tertiary care pediatric institution. During hospitalization, the patient underwent complete laboratory and radiological evaluation. The diagnosis of encephalitis complicated by Syndrome of Inappropriate Hormone Secretion (SIADH) was established. Adequate treatment led to complete recovery of the patient.

Conclusion: Encephalitis was suspected on the first day of neurological deterioration, upon the presentation to primary pediatrician. Urgent intervention of primary pediatrician was crucial for a good prognosis and prevention of complications. We would like to emphasize the Varicella prevention by administration of vaccine in the early ages.