Cerebral infarction complicating hemorrhagic shock and encephalopathy syndrome

Hemorrhagic shock and encephalopathy syndrome (HSES) is a severe, life-threatening illness affecting infants and young children. Patients stricken with this illness suffer high rates of neurological injury and mortality. We describe a child with HSES whose course was complicated by global cerebral infarction. This injury, although extensive and severe, was not appreciated during the initial examination of the child. Cerebral infarction during HSES may not be detected reliably unless imaging studies of the central nervous system are preformed after cerebral edema has resolved. CASE REPORT The patient was a 7-week-old girl born to a healthy 20-year-old woman. The infant had been healthy until 1 week prior to admission when she developed an upper respiratory tract infection.