Positive Tc-99m TRODAT Findings in Japanese Encephalitis

A 65-year-old female had high fever, headache, and myalgia for 7 days. She also had a resting tremor, shuffling gait, and bradykinesia. Brain MRI showed no specifically abnormal finding. Tc-99m ethyl cysteinate dimer (ECD) brain perfusion scan showed moderately decreased cerebral perfusion in bilateral frontal and bilateral temporal regions. Tc-99m [2-[[2-[[[3-(4-chlorophenyl)-8-methyl-8-azabicyclo [3,2,1]oct-2-yl]methyl](2-mercaptoethyl)amino]ethyl]amino]ethanethiolato(3-)-N2,N2′,S2,S2′]oxo-[1R-(exo-exo)](TRODAT) is a potential agent for imaging dopamine transporter that measures dopamine terminal innervation of the striatum. The Tc-99m TRODAT scan showed significantly decreased uptake in bilateral striata. IgM capture enzyme-linked immunoassay of serum and CSF were performed and showed Japanese encephalitis.