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Clinical Reasoning: A 17-Year-Old Adolescent Boy With New Altered Mental Status in the Pediatric Intensive Care Unit. Neurology 2024 Aug 13;103(3):e209709

Date

07/11/2024

Pubmed ID

38991195

Pubmed Central ID

PMC11247388

DOI

10.1212/WNL.0000000000209709

Scopus ID

2-s2.0-85198568252 (requires institutional sign-in at Scopus site)

Abstract

We present the case of a 17-year-old adolescent boy admitted to the Pediatric Intensive Care Unit with an extensive necrotizing soft tissue infection who subsequently developed altered mental status and autonomic instability. Altered mental status is a common occurrence in critically ill children with a broad differential of etiologies. After ruling out organic causes of encephalopathy, management is typically focused on avoiding deliriogenic agents, including benzodiazepines. Dopamine antagonist medications may also be administered adjunctively to manage agitation or delirium that is refractory to other measures. We review the workup and differential diagnosis for altered mentation in critically ill children and discuss the current understanding of a rare etiology of altered mental status in the pediatric population.

Author List

Ohman RT, Atchison C, Patel ND, Killien EY

Author

Namrata D. Patel MD Assistant Professor in the Neurology department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Adolescent
Diagnosis, Differential
Humans
Intensive Care Units, Pediatric
Male