CASE REPORT
Meningoencephalitis and postinflammatory hydrocephalus in the course of COVID-19 disease in newborn – the potential role of acetazolamide as add-on therapy to the standard treatment
1
Department of Neonatology and Neonatal Intensive Care Unit, Independent Public Healthcare, Puławy, Poland
2
Department of Veterinary Hygiene, Voivodship Veterinary Inspectorate, Lublin, Poland
Corresponding author
Sławomir Jan Wątroba
Department of Neonatology and Neonatal Intensive Care Unit, Independent Public Healthcare, Bema 1, 24-100 Puławy, Poland
Department of Neonatology and Neonatal Intensive Care Unit, Independent Public Healthcare, Bema 1, 24-100 Puławy, Poland
Ann Agric Environ Med. 2022;29(4):595-602
KEYWORDS
TOPICS
Biological agents posing occupational risk in agriculture, forestry, food industry and wood industry and diseases caused by these agents (zoonoses, allergic and immunotoxic diseases)State of the health of rural communities depending on various factors: social factors, accessibility of medical care, etc.
ABSTRACT
The topic of SARS-CoV-2 coronavirus infections in children is still complex and not fully understood. Acute meningoencephalitis
(ME) was not considered a common presentation of COVID-19 in paediatrics, however, over time, several paediatric patients
with ME associated with SARS-CoV-2 coronavirus infection have been described. The case report describes the clinical case
of a newborn admitted to the Neonatal Intensive Care Unit (NICU) on 11th day of life due to severe SARS-CoV-2 coronavirus
infection, who experienced multiple seizure episodes. The patient was diagnosed with ME and hydrocephalus. In the absence
of clinical improvement, despite the use of standard treatment, acetazolamide (ACZ) was used, achieving complete relief of
seizures and gradual regression of hydrocephalus. This means that ACZ can be considered as an add-on therapy to standard
treatment in cases of ME and postinflammatory hydrocephalus in the course of COVID-19 disease.
ABBREVIATIONS
ABB – acid-base balance; ACV – aciclovir; ACZ – acetazolamide; ALP – alkaline phosphatase; AMP – ampicillin; ARDS – acute
respiratory distress syndrome; CA – carbonate dehydratase; CMV – cytomagalovirus; CNS – central nervous system; CPE –
carbapenamase-producing Enterobacteriaceae; CSF – cerebrospinal fluid; CTX – cefotaxime; ECG – electrocardiogram; EEG
– electroencephalogram; FFP – fresh frozen plasma; FiO2 – oxygen concentration in the breathing mixture; FLC – fluconazole;
FR – ferritin; GBS – group B Streptococcus; GM – gentamicin; HFNC – high-flow nasal cannula; IVH – intraventricular
haemorrhage; LP – lumbar puncture; ME – meningoencephalitis; MP – meropenem; MRI – magnetic resonance imaging;
MRSA – methicillin-resistant Staphylococcus aureus; MSSA – methicillin-sensitive Staphylococcus aureus; NICU – neonatal
intensive care unit; PB – phenobarbital; PC – platelet concentrate; PIMS – paediatric inflammatory multisystem syndrome;
PVH – periventricular haemorrhage; RAV – right axillary vein; RSV – respiratory syncytial virus; RT-PCR – real-time reverse
transcription polymerase chain reaction; SI – singal intensity; TnT – troponin T; USG – ultrasonography; VAN – vancomycin
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