BENGALURU: A five-month-old girl child, who suffered Covid along with dengue co-infection, acute leukoencephalopathy (disease of white matter in the brain) and West syndrome (epileptic/infantile spasms, abnormal brain wave patterns), was successfully treated for Covid and dengue. Doctors from the Department of Paediatrics at the Bangalore Medical College and Research Institute have now published a case study on this in the Journal of Tropical Paediatrics.
The infant was presented with fever, refusal of feeding, developing altered sensorium, decreased responsiveness and convulsions. On day 10, an RT-PCR test was conducted for Covid, which turned positive. Dengue and Covid co-infection surmounted a massive cytokine storm leading to Acute Leukoencephalopathy with Restricted Diffusion, the studym titled “Acute Leukoencephalopathy with Restricted Diffusion in an Infant with Severe Covid-19 and Dengue Co-infection Progressing to West Syndrome’’, said.
“This is a rare and evolving case, and we could not find any other literature on such a case. Dengue fever is endemic in India and symptoms overlap with that of Covid,” said Dr Mallesh Kariyappa, Professor and Head, Department of Paediatrics, BMCRI, and one of the authors of the study.The infant was treated for dengue and Covid. By day 15 of the illness, the baby’s sensorium improved and she was started on nasogastric feeds. Following five-day therapy with intra-venous steroids, inflammatory markers registered a downward trend. On Day 16, a Covid test was done and it turned negative. The baby started taking direct breastfeeds on demand by Day 20 and was discharged.
“We found delayed development and loss of previously attained milestones. She developed repeated epileptic spasms (fits) in the months that followed and was diagnosed with West syndrome. We have to observe her during follow-ups, undertake stimulation and exercises through physiotherapy.,” Dr Mallesh said.