Case of the Week # 121

Miguel Octavio Sosa, MD

June 17-July 1, 2004

Barquisimeto- Venezuela

This is a G1P0 patient at 39 weeks, without prenatal care. Her history is unremarkable aside that she lives in the country, has not had any trauma, but had some fever that was not investigated by the time of the ultrasound examination:
The following images are ultrasound and CT of the fetus (and newborn)

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Because of financial constraints serological tests could not be performed and thus the diagnosis is ONLY PRESUMPTIVE. What would be your suggestion ?

NOTE: I will be out of the office and will not be able to answer my emails. So please send only one email with your 3 answers.

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Answer

This is a G1P0 patient at 39 weeks, without prenatal care. Her history is unremarkable aside that she lives in the country, has not had any trauma, but had some fever that was not investigated by the time of the ultrasound examination:
The following images are ultrasound and CT of the fetus (and newborn)

MV5
MV2
MV1
MV3
MV7
MV8
MV6

Because of financial constraints serological tests could not be performed and thus the diagnosis is ONLY PRESUMPTIVE.

 

The finding included a severe disruption of the brain due to a large hematoma. Because of endemic conditions and the febrile episode, it was suspected that the baby had a encephaloclastic hemorrhage from Dengue infection. There are no such reports I could find in Medline, but there are cases of fetal infection and the hemorrhagic complications are well-known.

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Figure 11:

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