key: cord-0755480-x2hjhdh4
authors: Hanna Huang, Y.; Jiang, Daniel; Huang, Jong T.
title: A Case of COVID-19 Encephalitis
date: 2020-05-06
journal: Brain Behav Immun
DOI: 10.1016/j.bbi.2020.05.012
sha: 5b39506edca3994ab88bd9271e017841d3583eb6
doc_id: 755480
cord_uid: x2hjhdh4

nan

We are writing to provide an update to the article published in Brain, Behavior, and Immunity published on April 17, 2020 titled "Meningoencephalitis without Respiratory Failure in a Young Female Patient with COVID-19 Infection in Downtown Los Angeles, Early April 2020" by Duong et al. We were the consulting infectious disease team in this case.

A 40-year-old woman with type 2 diabetes mellitus and obesity who presented with fever and syncope was admitted for encephalitis. Nasopharyngeal swab on admission was positive for SARS-CoV-2 and negative for influenza A and B viruses. Cerebrospinal fluid (CSF) was negative for both bacterial culture and herpes simplex virus type 1 on polymerase chain reaction (PCR) assay. CSF was subsequently found to be positive for SARS-CoV-2 on reverse transcription polymerase chain reaction (Quest Diagnostics, San Juan Capistrano, CA). The patient was started on hydroxychloroquine. Her mental status gradually improved and returned to baseline without neurological deficits by hospital day 12.

The majority COVID-19 patients present with respiratory symptoms and fever. Although rare, neurologic sequelae of COVID-19 have been reported, including syncope(1), Guillain-Barré syndrome(2), polyneuropathy(3), and stroke (4, 5) . We describe a case of SARS-CoV-2 infection that was entirely confined to the central nervous system, with no involvement of other organ systems. Given the patient's clinical presentation and positive PCR testing for SARS-CoV-2 in the CSF, we propose that this case is most consistent with SARS-CoV-2 encephalitis. To our knowledge, this presentation of COVID-19 has not yet been reported and is important to consider as an atypical manifestation of the viral infection.

COVID-19 in a Patient Presenting with Syncope and a Normal Chest X-ray

Guillain-Barré Syndrome Associated with SARS-CoV-2

Miller Fisher Syndrome and polyneuritis cranialis in COVID-19

Large-Vessel Stroke as a Presenting Feature of Covid-19 in the Young

Acute Cerebrovascular Disease Following COVID-19: A Single Center