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COVID-19 Post-Infectious Encephalitis Presenting With Delirium as an Initial Manifestation.
J Investig Med High Impact Case Rep. 2021 Jan-Dec; 9:23247096211029787.JI

Abstract

We report the case of a 65-year-old man with COVID-19 (coronavirus disease-2019) post-infectious encephalitis who presented with delirium as an initial manifestation. He had severe COVID-19 pneumonia and recovered with dexamethasone and tocilizumab. One week after discharge, he developed abnormal behavior and delirium without fever and respiratory symptoms. Brain magnetic resonance imaging showed no abnormalities. Cerebrospinal fluid showed pleocytosis and elevated protein concentrations and was negative for severe acute respiratory syndrome-coronavirus-2 RNA. No anti-neuronal autoantibodies against intracellular and neuronal surface proteins were detected. The cerebrospinal fluid inflammatory changes compatible with post-infectious encephalitis, and the patient recovered with intravenous methylprednisolone and intravenous immunoglobulin therapy. Delirium could be an initial symptom of post-infectious encephalitis in older adults with COVID-19, and these patients may require immunosuppressive therapy.

Authors+Show Affiliations

Division of Neurology, Department of Medicine, Nihon University School of Medicine, Tokyo, Japan.Division of Neurology, Department of Medicine, Nihon University School of Medicine, Tokyo, Japan.Division of Neurology, Department of Medicine, Nihon University School of Medicine, Tokyo, Japan.Division of Neurology, Department of Medicine, Nihon University School of Medicine, Tokyo, Japan.Division of Respiratory Medicine, Department of Medicine, Nihon University School of Medicine.Division of Respiratory Medicine, Department of Medicine, Nihon University School of Medicine.Division of Neurology, Department of Medicine, Nihon University School of Medicine, Tokyo, Japan.

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

34229469

Citation

Hara, Makoto, et al. "COVID-19 Post-Infectious Encephalitis Presenting With Delirium as an Initial Manifestation." Journal of Investigative Medicine High Impact Case Reports, vol. 9, 2021, p. 23247096211029787.
Hara M, Kouda K, Mizoguchi T, et al. COVID-19 Post-Infectious Encephalitis Presenting With Delirium as an Initial Manifestation. J Investig Med High Impact Case Rep. 2021;9:23247096211029787.
Hara, M., Kouda, K., Mizoguchi, T., Yokota, Y., Hayashi, K., Gon, Y., & Nakajima, H. (2021). COVID-19 Post-Infectious Encephalitis Presenting With Delirium as an Initial Manifestation. Journal of Investigative Medicine High Impact Case Reports, 9, 23247096211029787. https://doi.org/10.1177/23247096211029787
Hara M, et al. COVID-19 Post-Infectious Encephalitis Presenting With Delirium as an Initial Manifestation. J Investig Med High Impact Case Rep. 2021 Jan-Dec;9:23247096211029787. PubMed PMID: 34229469.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - COVID-19 Post-Infectious Encephalitis Presenting With Delirium as an Initial Manifestation. AU - Hara,Makoto, AU - Kouda,Kento, AU - Mizoguchi,Tomotaka, AU - Yokota,Yuki, AU - Hayashi,Kentaro, AU - Gon,Yasuhiro, AU - Nakajima,Hideto, PY - 2021/7/7/entrez PY - 2021/7/8/pubmed PY - 2021/7/13/medline KW - COVID-19 KW - SARS-CoV-2 KW - delirium KW - post-infectious encephalitis SP - 23247096211029787 EP - 23247096211029787 JF - Journal of investigative medicine high impact case reports JO - J Investig Med High Impact Case Rep VL - 9 N2 - We report the case of a 65-year-old man with COVID-19 (coronavirus disease-2019) post-infectious encephalitis who presented with delirium as an initial manifestation. He had severe COVID-19 pneumonia and recovered with dexamethasone and tocilizumab. One week after discharge, he developed abnormal behavior and delirium without fever and respiratory symptoms. Brain magnetic resonance imaging showed no abnormalities. Cerebrospinal fluid showed pleocytosis and elevated protein concentrations and was negative for severe acute respiratory syndrome-coronavirus-2 RNA. No anti-neuronal autoantibodies against intracellular and neuronal surface proteins were detected. The cerebrospinal fluid inflammatory changes compatible with post-infectious encephalitis, and the patient recovered with intravenous methylprednisolone and intravenous immunoglobulin therapy. Delirium could be an initial symptom of post-infectious encephalitis in older adults with COVID-19, and these patients may require immunosuppressive therapy. SN - 2324-7096 UR - https://www.unboundmedicine.com/medline/citation/34229469/COVID-19_Post-Infectious_Encephalitis_Presenting_With_Delirium_as_an_Initial_Manifestation. L2 - https://journals.sagepub.com/doi/10.1177/23247096211029787?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -