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Delayed onset of fatal encephalitis in a COVID-19 positive patient
- Source :
- International Journal of Neuroscience
- Publication Year :
- 2021
- Publisher :
- Informa UK Limited, 2021.
-
Abstract
- The SARS-nCoV-2019 epidemic has spread since December 2019, quickly gaining worldwide attention. Symptoms consist of fever, cough and breathing difficulties. An increasing number of studies are focusing on neurological manifestations. In addition to the typical ageusia and anosmia, up to 30% of cases can present headache, nausea and vomiting. More serious neurological manifestations, such as encephalitis, thrombosis and cerebral haemorrhage have been reported.We described the case of a 47-year-old man who tested positive for COVID-19 virus in early March 2020. After two negative nasopharyngeal swabs, 41 days after the diagnosis of COVID-19 infection, he developed intense headache with fever, and he was hospitalized. He had subsequent generalized epileptic seizures and intubation was necessary. Contrast Head MRI was negative for brain abscesses or tumours but detected severe vasogenic oedema of the white matter with 10 mm shift of the midline and compression of the right lateral ventricle. Massive cortisone support therapy was ineffective. We diagnosed brain death on day 43 from the infection diagnosis.COVID-19 virus can reach the brain, penetrating into the neuronal cells through the interaction between the spike protein S1 and the host ACE-2 receptor, expressed in the capillary endothelium. We believe that in this infection, the pro-inflammatory state induced by the cytokine storm can cause a cerebral cell-mediated response, with subsequent vasodilatation and brain oedema.To our knowledge, this is the first description of a delayed onset cell-mediated encephalitis caused by COVID-19 virus after more than 40 days from the diagnosis.
- Subjects :
- 0301 basic medicine
Pediatrics
medicine.medical_specialty
2019-20 coronavirus outbreak
fatal
Coronavirus disease 2019 (COVID-19)
business.industry
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)
General Neuroscience
COVID-19
Encephalitis
infection
Delayed onset
General Medicine
medicine.disease
Positive patient
03 medical and health sciences
030104 developmental biology
0302 clinical medicine
medicine
Breathing
business
030217 neurology & neurosurgery
Subjects
Details
- Language :
- English
- ISSN :
- 15435245 and 00207454
- Database :
- OpenAIRE
- Journal :
- International Journal of Neuroscience
- Accession number :
- edsair.doi.dedup.....c1e7ecf94bd5ccb766abf6847997845c
- Full Text :
- https://doi.org/10.1080/00207454.2021.1886095