A 4-year-old girl was admitted to the pediatric ward with cough, cold, fever and altered mental status. Her condition deteriorated and she developed status epilepticus. Imaging showed abnormalities in her thalamus and brainstem. She was diagnosed with acute necrotizing encephalopathy, likely caused by influenza A virus. This is a rare neurological syndrome seen in young children following viral infections, characterized by symmetric brain lesions in specific areas. The outcome ranges from full recovery to death.