HIV in Children
March 2018 NEWSLETTER


HIV IN CHILDREN
March 2018 Newsletter
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GRAND ROUNDS
A 4 months old HIV exposed female infant presented to emergency department with multifocal convulsion, dystonic posturing and altered sensorium. She was born at 35-36 weeks of gestation, by emergency caesarean section due to cord prolapse. Mother was diagnosed to be HIV infected before pregnancy and was on ART consisting of AZT, lamivudine (3TC) and nevirapine (NVP) which she continued till date. Her CD4 count was 560 cell/cumm at the time of delivery. Baby also received single dose NPV after birth and then AZT prophylaxis for 6 weeks. Child was exclusively breastfeed. On examination, the child had acidotic breathing with hepatomegaly. Arterial blood gas analysis showed severe metabolic acidosis (pH-7.14, bicarbonate-4.2 mEq/L) with high anion gap of 30. Septic screen was negative. CT brain revealed bilateral basal ganglia hypodensities suggestive of metabolic encephalopathy (Figure 1).

What is the cause of the acute encephalopathy?

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Pediatric Oncall Book Store
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