Ischaemic stroke; not just a disease of adulthood

摘要

A previously well 2-year-old boy was admitted to a district general hospital with a 7-day history of fever, lethargy, cough and vomiting. Provisional diagnosis of chest infection was made with Escherichia colt isolated from blood cultures. Two days later, despite appropriate antibiotics, he deteriorated, developing right upper quadrant pain followed by acute deterioration in conscious level. The patient was resuscitated, intubated and paediatric intensive care unit ( PICU) retrieval requested. Hypotension requiring inotropic support and coagulopathy suggested a septic picture. Surgical review and abdominal ultrasound scan were normal. In PICU inotropic requirement reduced, but altered conscious level persisted despite cessation of sedation.