A previously normal, 5-year-old boy developed a rapidly progressive neurological illness three days following diagnosis and treatment of a streptococcal pharyngitis. He had quadriparesis, then developed pseudobulbar palsy and respiratory failure, and died eight weeks later. At postmortem examination, the neuropathological findings were diagnostic of subacute necrotizing encephalomyelopathy, a disease primarily of infancy, which when present in older children almost always follows the course of a chronic neurological illness.
Eisengart MA, Powers JM, Rose AL. Subacute Necrotizing Encephalomyelopathy: Rapidly Fatal Course of Leigh Disease in a 5-year-old Child. Am J Dis Child. 1974;127(5):730–732. doi:10.1001/archpedi.1974.02110240116018
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