{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,22]],"date-time":"2026-04-22T03:02:49Z","timestamp":1776826969759,"version":"3.51.2"},"reference-count":13,"publisher":"BMJ","issue":"6","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2022,5,17]]},"published-print":{"date-parts":[[2022,6]]},"abstract":"<jats:p>We report a case of a preschool age girl, previously healthy, referred to our hospital on ventilatory support with a history of vomiting, headache, and rapid neurological worsening within 24 hours in the form of seizures, encephalopathy and loss of consciousness. On presentation, she was deeply comatose with dilated non-reactive pupils, absent brainstem reflexes and flaccid quadriplegia. Diagnosis of acute haemorrhagic leukoencephalitis was considered based on laboratory and neuroimaging findings. MRI of the brain showed fluffy white matter hyperintensities and microhaemorrhages in bilateral cerebral hemispheres and thalami. Aggressive treatment with methylprednisolone, plasmapheresis and intravenous immunoglobulin showed dramatic improvement with no neurological sequelae. Our case is unique in a way that despite the hyperacute onset and rapid deterioration, with a fulminant course in the intensive care unit, the child recovered dramatically with aggressive management.<\/jats:p>","DOI":"10.1136\/bcr-2021-246654","type":"journal-article","created":{"date-parts":[[2022,6,9]],"date-time":"2022-06-09T12:25:33Z","timestamp":1654777533000},"page":"e246654","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Paediatric acute haemorrhagic leukoencephalitis"],"prefix":"10.1136","volume":"15","author":[{"given":"Harshita","family":"Bamnawat","sequence":"first","affiliation":[{"name":"Pediatrics, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4356-6883","authenticated-orcid":false,"given":"Daisy","family":"Khera","sequence":"additional","affiliation":[{"name":"Pediatrics, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4578-2184","authenticated-orcid":false,"given":"Siyaram","family":"Didel","sequence":"additional","affiliation":[{"name":"Pediatrics, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sarbesh","family":"Tiwari","sequence":"additional","affiliation":[{"name":"Radiodiagnosis, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2022,6,9]]},"reference":[{"key":"2025082710065318000_15.6.e246654.1","doi-asserted-by":"publisher","DOI":"10.1177\/088307389701200707"},{"key":"2025082710065318000_15.6.e246654.2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.59.8.1224"},{"key":"2025082710065318000_15.6.e246654.3","doi-asserted-by":"crossref","first-page":"48","DOI":"10.4103\/1817-1745.84408","article-title":"Acute hemorrhagic encephalomyelitis in childhood: case report and literature review","volume":"6","author":"Borlot","year":"2011","journal-title":"J Pediatr Neurosci"},{"key":"2025082710065318000_15.6.e246654.4","doi-asserted-by":"crossref","DOI":"10.3389\/fneur.2020.00899","article-title":"Acute hemorrhagic leukoencephalitis: a case and systematic review of the literature","volume":"11","author":"Grzonka","year":"2020","journal-title":"Front Neurol"},{"key":"2025082710065318000_15.6.e246654.5","doi-asserted-by":"crossref","first-page":"653","DOI":"10.1007\/s00234-021-02667-1","article-title":"Acute hemorrhagic leukoencephalitis in a COVID-19 patient-a case report with literature review","volume":"63","author":"Varadan","year":"2021","journal-title":"Neuroradiology"},{"key":"2025082710065318000_15.6.e246654.6","article-title":"Acute Hemorrhagic Leukoencephalitis (Hurst Disease) Secondary to H1N1 in a Child - 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