Acute necrotizing encephalopathy of childhood - an atypical disease with typical manifestations: a rare case report

Acute necrotizing encephalopathy of childhood (ANEC) is a rare entity characterized by high grade fever, respiratory or gastrointestinal infection accompanying with rapid alteration of consciousness and/ or seizures. This case report will discuss the diagnostic approach in 2.5-year-old male child with fever, vomiting and altered sensorium. Empirical therapy for meningoencephalitis with supportive therapy was administered. Diagnostic approach of ANEC consists of clinical manifestation, laboratory examination, cerebrospinal fluid (CSF) analysis, and neuroimaging interpretation. The patient had high liver enzyme, normal CSF analysis with appearances of edema, hemorrhage and necrosis with symmetrical lesion involving bilateral thalami in brain magnetic resonance imaging (MRI).