Abenza-Abildúa MJ, Novo-Aparicio S, Moreno-Zabaleta R, Algarra-Lucas MC, Rojo Moreno-Arcones B, Salvador-Maya MÁ, Navacerrada-Barrero FJ, Ojeda-Ruíz de Luna J, Pérez-López C, Fraile-Vicente JM, Suárez-García I, Suarez-Gisbert E, Palacios-Castaño JA, Ramirez-Prieto MT. Encephalopathy in severe SARS-CoV2 infection: Inflammatory or infectious?
Int J Infect Dis 2020;
98:398-400. [PMID:
32712426 PMCID:
PMC7378010 DOI:
10.1016/j.ijid.2020.07.020]
[Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2020] [Revised: 07/05/2020] [Accepted: 07/19/2020] [Indexed: 11/23/2022] Open
Abstract
Concerning the letter by Moriguchi et al., we describe our experience with a case of encephalopathy with and atypical damage on magnetic resonance imaging (MRI) in a patient with severe infection due to the SARS-CoV2 virus. A 56-year-old woman, without previous pathologies, developed cough, fever, and respiratory failure for five days, after returning from a 6-day trip to Venice. Chest radiography shows a large bilateral interstitial infiltrate. In the first 24 hours, she was admitted to the Intensive Care Unit (ICU) for severe respiratory failure and positive protein chain reaction-PCR in nasal exudate. She needed intubation for ten days. In the first 48 hours outside the ICU, she developed an acute confusional syndrome (hyperactive delirium). Neurological examination showed temporal-spatial disorientation and incoherent fluent speech. An electroencephalogram (EEG) showed generalized hypovoltaic activity. Cranial magnetic resonance imaging showed a bilateral and symmetrical increase in the supratentorial white matter's signal intensity, with a discrete thickening of both temporal lobes, with a slight increase in signal intensity and a sequence of normal diffusion. The lumbar puncture showed no changes (glucose 71 mg/dL, protein 30 mg/dL, 1 leukocyte). Within 72 hours of starting symptoms, she was neurologically asymptomatic. Our final diagnosis was an inflammatory encephalopathy related to a SARS-CoV2 infection.
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