{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T13:49:54Z","timestamp":1782913794531,"version":"3.54.5"},"reference-count":10,"publisher":"BMJ","issue":"7","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2026,6,15]]},"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:p>Lead encephalopathy is a rare but life-threatening neurotoxic emergency in children. Although rare, lead encephalopathy can mimic infectious encephalitis leading to delay in diagnosis and management in resource-limited settings. A toddler belonging to poor socioeconomic strata presented with non-bilious vomiting for 6\u2009days, intermittent fever for 3\u2009days, seizures and rapidly deteriorating neurological status a few hours prior to arrival in triage. A thorough history later found the child\u2019s visits to a battery recycling unit. Blood lead levels (BLL) were 88.1 mcg\/dL. Chelation therapy with intramuscular dimercaprol (British anti-Lewisite) along with calcium disodium EDTA was administered via intramuscular injection for 5\u2009days but the child deteriorated due to severe brain herniation, resulting in demise. In cases of unexplained encephalopathy in children (after ruling out infectious causes) along with the presence of environmental and occupational risk factors with biochemical support, lead toxicity must be considered early. Early targeted history taking and chelation are essential to prevent irreversible damage.<\/jats:p>","DOI":"10.1136\/bcr-2025-271913","type":"journal-article","created":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T13:28:00Z","timestamp":1782912480000},"page":"e271913","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Lead encephalopathy mimicking as acute encephalitis syndrome in a child"],"prefix":"10.1136","volume":"19","author":[{"given":"Savi","family":"Setia","sequence":"first","affiliation":[{"name":"Pediatrics, All India Institute of Medical Sciences Bathinda, Bathinda, Punjab, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ramandeep","family":"Singh","sequence":"additional","affiliation":[{"name":"Radiodiagnosis, All India Institute of Medical Sciences - Bathinda, Bathinda, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-0739-6882","authenticated-orcid":false,"given":"Roshwanth","family":"A","sequence":"additional","affiliation":[{"name":"Pediatrics, All India Institute of Medical Sciences Bathinda, Bathinda, Punjab, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-4949-9706","authenticated-orcid":false,"given":"Arvinder","family":"Wander","sequence":"additional","affiliation":[{"name":"Pediatrics, All India Institute of Medical Sciences Bathinda, Bathinda, Punjab, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,7,1]]},"reference":[{"key":"2026070106200983000_19.7.e271913.1","doi-asserted-by":"crossref","first-page":"687","DOI":"10.1186\/s12887-024-04871-3","article-title":"Lead encephalopathy presenting as status epilepticus: a case report","volume":"24","author":"Kamal","year":"2024","journal-title":"BMC Pediatr"},{"key":"2026070106200983000_19.7.e271913.2","first-page":"23","article-title":"Occupational lead exposure mimicking autoimmune encephalitis in a beautician","volume":"32","author":"Manuraj","year":"2025","journal-title":"Toxicol Int"},{"key":"2026070106200983000_19.7.e271913.3","doi-asserted-by":"crossref","first-page":"893767","DOI":"10.3389\/fneur.2022.893767","article-title":"Management of Cerebral Herniation Secondary to Lead Encephalopathy: A Case Report","volume":"13","author":"Das","year":"2022","journal-title":"Front Neurol"},{"key":"2026070106200983000_19.7.e271913.4","first-page":"953","article-title":"Lead poisoning in children: clinical manifestations and outcome","volume":"77","author":"Mitra","year":"2010","journal-title":"Indian J Pediatr"},{"key":"2026070106200983000_19.7.e271913.5","first-page":"114","article-title":"Lead toxicity part II: the role of free radical damage and the use of antioxidants in the pathology and treatment of lead toxicity","volume":"11","author":"Patrick","year":"2006","journal-title":"Altern Med Rev"},{"key":"2026070106200983000_19.7.e271913.6","doi-asserted-by":"crossref","unstructured":"Bellinger DC , Malin A , Wright RO . The neurodevelopmental toxicity of lead: History, epidemiology, and public health implications. Adv Neurotoxicol 2018.","DOI":"10.1016\/bs.ant.2018.03.009"},{"key":"2026070106200983000_19.7.e271913.7","unstructured":"Needleman HL . Low level lead exposure: history and discovery. Environ Res 2009;109."},{"key":"2026070106200983000_19.7.e271913.8","doi-asserted-by":"crossref","unstructured":"Sharma R . Lead encephalopathy. 2025. doi:10.53347\/rID-215125","DOI":"10.53347\/rID-215125"},{"key":"2026070106200983000_19.7.e271913.9","doi-asserted-by":"crossref","DOI":"10.3389\/fped.2025.1580368","article-title":"Lead poisoning in a 10-year-old boy with cyclic vomiting as the first symptom: a case report","volume":"13","author":"Ding","year":"2025","journal-title":"Front Pediatr"},{"key":"2026070106200983000_19.7.e271913.10","doi-asserted-by":"crossref","first-page":"119528","DOI":"10.1016\/j.envres.2024.119528","article-title":"Assessment of prevalence of elevated blood lead levels and risk factors among children and pregnant women in Bihar, India","volume":"259","author":"Lu","year":"2024","journal-title":"Environ Res"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2025-271913","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T13:28:09Z","timestamp":1782912489000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2025-271913"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7]]},"references-count":10,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2026,7,1]]},"published-print":{"date-parts":[[2026,7]]}},"alternative-id":["10.1136\/bcr-2025-271913"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2025-271913","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7]]}}}