1. Encephalopathy in severe SARS-CoV2 infection: Inflammatory or infectious?
- Author
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Francisco José Navacerrada-Barrero, Inés Suárez-García, Blas Rojo Moreno-Arcones, Miguel Ángel Salvador-Maya, Juan Antonio Palacios-Castaño, Susana Novo-Aparicio, Maria Carmen Algarra-Lucas, C. Pérez-López, M T Ramírez-Prieto, Joaquín Ojeda-Ruíz de Luna, R Moreno-Zabaleta, María José Abenza-Abildúa, José María Fraile-Vicente, and Eugenio Suarez-Gisbert
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0301 basic medicine ,Microbiology (medical) ,Pneumonia, Viral ,030106 microbiology ,Encephalopathy ,Neurological symptoms ,Neurological examination ,macromolecular substances ,Asymptomatic ,Article ,lcsh:Infectious and parasitic diseases ,law.invention ,Betacoronavirus ,03 medical and health sciences ,0302 clinical medicine ,law ,medicine ,Humans ,lcsh:RC109-216 ,030212 general & internal medicine ,Pandemics ,Brain Diseases ,medicine.diagnostic_test ,SARS-CoV-2 ,business.industry ,Lumbar puncture ,musculoskeletal, neural, and ocular physiology ,Neuroradiological lesions ,COVID-19 ,Magnetic resonance imaging ,General Medicine ,Middle Aged ,medicine.disease ,Magnetic Resonance Imaging ,Intensive care unit ,Hospitalization ,Coronavirus ,Intensive Care Units ,Infectious Diseases ,nervous system ,Respiratory failure ,Anesthesia ,SARS-CoV2 ,Delirium ,Female ,medicine.symptom ,Coronavirus Infections ,business - Abstract
Highlights • After severe SARS-CoV2 infection, radiological abnormalities such as encephalopathies may be seen. • An extensive radiological encephalopathy may not correlate with abnormalities in cerebrospinal fluid. • An extensive radiological encephalopathy does not correlate with the severity of symptoms., 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.
- Published
- 2020
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