Encephalopathy in severe SARS-CoV2 infection: Inflammatory or infectious?

Autor: 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, Eugenio Suarez-Gisbert
Jazyk: angličtina
Rok vydání: 2020
Předmět:
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
Zdroj: International Journal of Infectious Diseases
International Journal of Infectious Diseases, Vol 98, Iss, Pp 398-400 (2020)
ISSN: 1201-9712
DOI: 10.1016/j.ijid.2020.07.020
Popis: 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.
Databáze: OpenAIRE
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