Open AccessMENINGO-ENCEPHALITIS IN A MIDDLE-AGED WOMAN HOSPITALIZED FOR COVID-19
Author(s) -
Pavel Dyachenko,
Olha Ivanivna Smiianova,
Anatoly G Dyachenko
Publication year - 2021
Publication title -
wiadomości lekarskie
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.133
H-Index - 14
eISSN - 2719-342X
pISSN - 0043-5147
DOI - 10.36740/wlek202105142
Subject(s) - medicine , cerebrospinal fluid , fluid attenuated inversion recovery , brain biopsy , encephalitis , pneumonia , levofloxacin , dexamethasone , ganciclovir , gastroenterology , central nervous system , immunology , radiology , magnetic resonance imaging , antibiotics , virus , human cytomegalovirus , biology , microbiology and biotechnology
The aim: To pay attention of clinicians to possible lesions of the central nervous system (encephalitis) in patients with COVID-19. Case presentation: A 44-year-old woman was admitted to our clinic because of 2-month-history of mild fever, bilateral lower lobe pneumonia, respiratory failure, generalized weakness, and some neurologic symptoms. SARS-CoV-2 RNA was detected in nasopharyngeal swab. Chest CT demonstrated bilateral pulmonary poly segmental consolidations in the mid and lower zones. Focal hyper intensive abnormalities in various parts of the left hemisphere were found at MR brain imaging in T2WI, and T2 FLAIR mode. Cerebrospinal fluid (CSF) examination showed a white cell count of 31/uL (normal <5/uL), protein 0.73 g/L (0.15-0.45), and glucose 1.4 mmole/L (2.2-3.9). Standard CSF neuroviral PCR panel and PCR for SARS-CoV-2 were negative. She was treated with ganciclovir, and dexamethasone. Due to suspected tuberculosis meningitis (cytosis, decreased level of protein and glucose), she also received ex juvantibus a course of anti-TB therapy (isoniazid, kanamycin, and levofloxacin) and made a steady improvement.Conclusion: This case shows that SARS-CoV-2 in association with other pathogens may cause various lesions of the CNS accompanied by severe neurological manifestations in adults.