Acute necrotizing encephalopathy secondary to sepsis

A routine blood test showed increased white blood cell (WBC) (17.47×109/L; neutrophils 86%) and decreased platelet (37×109/L) counts; coagulant dysfunction (fibrin degradation products [FDP], 122.9 μg/mL; D-dimer, 6283 μg/L; prothrombin time [PT], 25 seconds; activated partial thromboplastin time [APTT], 44.1 seconds) was also observed. Serum viral studies (hepatitis B virus [HBV], hepatitis C virus [HCV], human immunodeficiency virus [HIV]) and syphilis serology tests were all negative. (E) ADC revealed symmetrical concentric thalamic lesions: reduced signal intensity in the core (red arrow), corresponding to diffusion restriction; and increased signal in the outer layer (blue arrow), corresponding to vasogenic edema and diffusion enhancement.