Shahwar Yousuf retweetet

Critical and timely discussion at #SCCM2025 about pediatric influenza necrotizing encephalopathy, which we are seeing more of this season and is proving to be rapid and deadly. Take home points:
-elevated IL-6 and plasma and CSF
- flu + altered mental status = CT scan, knowing we will overscan, but pts only survive if caught early
- treat aggressively with pulse steroids, IVIG, plasma exchange, and tocilizumab (Cincinnati protocol below shared by @mommimaya and @pccm_doc)
- ask for flu sub typing as H5 is associated
- consider testing patient and siblings for RANBP2 mutation
- report to CDC: severeflu@cdc.gov
#PedsICU #ICU

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