<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>0001-6002</journal-id>
<journal-title><![CDATA[Acta Médica Costarricense]]></journal-title>
<abbrev-journal-title><![CDATA[Acta méd. costarric]]></abbrev-journal-title>
<issn>0001-6002</issn>
<publisher>
<publisher-name><![CDATA[Colegio de Médicos y Cirujanos de Costa Rica]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S0001-60022021000400223</article-id>
<article-id pub-id-type="doi">10.51481/amc.v63i4.1113</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Encefalitis aguda necrotizante, diagnóstico retador en una niña con deterioro neurológico súbito]]></article-title>
<article-title xml:lang="en"><![CDATA[Acute necrotizing encephalopathy, a challenging diagnosis in a child with sudden neurological deterioration]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Tautiva-Rojas]]></surname>
<given-names><![CDATA[María]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Bogantes-Ledezma]]></surname>
<given-names><![CDATA[Sixto]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Caja Costarricense de Seguro Social Hospital Nacional de Niños ]]></institution>
<addr-line><![CDATA[San José ]]></addr-line>
<country>Costa Rica</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Caja Costarricense de Seguro Social Hospital Nacional de Niños ]]></institution>
<addr-line><![CDATA[San José ]]></addr-line>
<country>Costa Rica</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>12</month>
<year>2021</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>12</month>
<year>2021</year>
</pub-date>
<volume>63</volume>
<numero>4</numero>
<fpage>223</fpage>
<lpage>228</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.sa.cr/scielo.php?script=sci_arttext&amp;pid=S0001-60022021000400223&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.sa.cr/scielo.php?script=sci_abstract&amp;pid=S0001-60022021000400223&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.sa.cr/scielo.php?script=sci_pdf&amp;pid=S0001-60022021000400223&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen La encefalopatía aguda necrotizante (EAN) es una entidad muy poco frecuente, con compromiso neurológico importante, en la cual los hallazgos radiológicos de lesiones en sistema nervioso central necróticas, simétricas y multifocales son esenciales para diagnosticarla. Se asocia a una respuesta inmune exagerada. Se reporta el caso de una niña de 1 año y 3 meses, previamente sana y con un deterioro neurológico súbito posterior a un cuadro febril de un día y convulsiones, con necesidad de reanimación y ventilación. La neuroimagen demostró las lesiones características de EAN y se manejó con tratamiento inmunomodulador así como antibiótico y antiviral. Se aisló únicamente un adenovirus y rinovirus en muestra respiratoria. La paciente sobrevivió con morbilidad importante como secuelas neurológicas, traqueostomía y gastrostomía. Este es el primer de EAN caso publicado en Costa Rica.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract Acute necroziting encephalopathy (ANE) is a rare and serious entity, with significant neurological involvement, in which the radiological findings of symmetric and multifocal necroziting lesions in central nervous system are characteristic. It is an immune-mediated disease with incompletely recognized pathogenesis. We present the case of a 1 year old child, previously healthy, that presented with acute neurological deterioration after a day of fever and seizures. She required reanimation and ventilation. Typical findings of ANE were found in neuroimaging and she was treated with inmunomodulating therapy, antibiotics and antivirals. Only rhinovirus and adenovirus were isolated in respiratory sample. The patient survived with significant neurological sequelae. This is the first case of ANE published in Costa Rica.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[encefalopatía aguda febril]]></kwd>
<kwd lng="es"><![CDATA[trastorno neurológico]]></kwd>
<kwd lng="es"><![CDATA[convulsiones]]></kwd>
<kwd lng="en"><![CDATA[acute febrile encephalopathy]]></kwd>
<kwd lng="en"><![CDATA[nervous system diseases]]></kwd>
<kwd lng="en"><![CDATA[seizures]]></kwd>
</kwd-group>
</article-meta>
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