COVID-19 meningitis without pulmonary involvement with positive cerebrospinal fluid PCR.

Autor: Khodamoradi Z; Shiraz University of Medical Sciences, Shiraz, Iran., Hosseini SA; Shiraz University of Medical Sciences, Shiraz, Iran., Gholampoor Saadi MH; Shiraz University of Medical Sciences, Shiraz, Iran., Mehrabi Z; Shiraz University of Medical Sciences, Shiraz, Iran., Sasani MR; Shiraz University of Medical Sciences, Shiraz, Iran., Yaghoubi S; Shiraz University of Medical Sciences, Shiraz, Iran.
Jazyk: angličtina
Zdroj: European journal of neurology [Eur J Neurol] 2020 Dec; Vol. 27 (12), pp. 2668-2669.
DOI: 10.1111/ene.14536
Abstrakt: Background: Coronavirus disease 2019 (COVID-19) typically presents with respiratory illness ranging in severity. Neurological complications of the disease remain largely unknown. Herein, we discuss the case of a woman diagnosed with COVID-19 meningitis following two positive cerebrospinal fluid (CSF) RT-PCR assays, and highlight the importance of recognizing the neurological manifestations of the disease.
Case Report: The patient was a 49-year-old woman with a history of hypertension who presented with non-specific symptoms (fever, headache, malaise, nausea/vomiting). Chest computed tomography (CT) revealed a lack of pulmonary involvement and oropharyngeal/nasopharyngeal RT-PCR was negative for COVID-19. A lumbar puncture was performed on the third day of admission and the CSF analysis elucidated a viral pattern, but the CSF bacterial culture and RT-PCR assay for herpes simplex virus were both negative. Surprisingly, the CSF RT-PCR for COVID-19 was positive. The diagnosis of COVID-19 meningitis was made and the patient was treated solely with Kaletra ® , with a second CSF analysis confirming our unique finding 1 week later. The patient's clinical characteristics improved progressively, and she was discharged in excellent general condition after 21 days.
Conclusion: In contrast to what was originally believed, the SARS-CoV-2 can cause meningitis in isolation, perhaps by crossing the blood-brain barrier. Hence, it seems essential that physicians maintain a high index of suspicion for neurological involvement among COVID-19 patients, with early CSF analysis and brain imaging sometimes being indicated.
(© 2020 European Academy of Neurology.)
Databáze: MEDLINE
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