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COVID-19 related acute necrotizing encephalopathy presenting in the early postoperative period

Besides respiratory and gastrointestinal symptoms, SARS-CoV-2 also has potential neurotropic effects. Acute hemorrhagic necrotizing encephalopathy is a rare complication of Covid-19. This article presents a case of an 81-year-old female, fully vaccinated, who underwent laparoscopic transhiatal esoph...

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Autores principales: Symeonidou, Elissavet, Dimitriadou, Androniki, Morsi-Yeroyannis, Antonios, Sidiropoulou, Maria S., Gkoutziotis, Ioannis, Petras, Panagiotis, Mpallas, Konstantinos
Formato: Online Artículo Texto
Lenguaje:English
Publicado: UMF “Gr. T. Popa” Iasi Publishing House 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10246599/
https://www.ncbi.nlm.nih.gov/pubmed/37293685
http://dx.doi.org/10.22551/2023.39.1002.10246
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author Symeonidou, Elissavet
Dimitriadou, Androniki
Morsi-Yeroyannis, Antonios
Sidiropoulou, Maria S.
Gkoutziotis, Ioannis
Petras, Panagiotis
Mpallas, Konstantinos
author_facet Symeonidou, Elissavet
Dimitriadou, Androniki
Morsi-Yeroyannis, Antonios
Sidiropoulou, Maria S.
Gkoutziotis, Ioannis
Petras, Panagiotis
Mpallas, Konstantinos
author_sort Symeonidou, Elissavet
collection PubMed
description Besides respiratory and gastrointestinal symptoms, SARS-CoV-2 also has potential neurotropic effects. Acute hemorrhagic necrotizing encephalopathy is a rare complication of Covid-19. This article presents a case of an 81-year-old female, fully vaccinated, who underwent laparoscopic transhiatal esophagectomy due to gastroesophageal junction cancer. In the early postoperative period, the patient developed persistent fever accompanied by acute quadriplegia, impaired consciousness, and no signs of respiratory distress. Imaging with Computed Tomography and Magnetic Resonance revealed multiple bilateral lesions both in gray and white matter, as well as pulmonary embolism. Covid-19 infection was added to the differential diagnosis three weeks later, after other possible causes were excluded. The molecular test obtained at that time for coronavirus was negative. However, the high clinical suspicion index led to Covid-19 antibody testing (IgG and IgA), which confirmed the diagnosis. The patient was treated with corticosteroids with noticeable clinical improvement. She was discharged to a rehabilitation center. Six months later, the patient was in good general condition, although a neurological deficit was still present. This case indicates the significance of a high clinical suspicion index, based on a combination of clinical manifestations and neuroimaging, and the confirmation of the diagnosis with molecular and antibody testing. Constant awareness of a possible Covid-19 infection among hospitalized patients is mandatory.
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spelling pubmed-102465992023-06-08 COVID-19 related acute necrotizing encephalopathy presenting in the early postoperative period Symeonidou, Elissavet Dimitriadou, Androniki Morsi-Yeroyannis, Antonios Sidiropoulou, Maria S. Gkoutziotis, Ioannis Petras, Panagiotis Mpallas, Konstantinos Arch Clin Cases Case Report Besides respiratory and gastrointestinal symptoms, SARS-CoV-2 also has potential neurotropic effects. Acute hemorrhagic necrotizing encephalopathy is a rare complication of Covid-19. This article presents a case of an 81-year-old female, fully vaccinated, who underwent laparoscopic transhiatal esophagectomy due to gastroesophageal junction cancer. In the early postoperative period, the patient developed persistent fever accompanied by acute quadriplegia, impaired consciousness, and no signs of respiratory distress. Imaging with Computed Tomography and Magnetic Resonance revealed multiple bilateral lesions both in gray and white matter, as well as pulmonary embolism. Covid-19 infection was added to the differential diagnosis three weeks later, after other possible causes were excluded. The molecular test obtained at that time for coronavirus was negative. However, the high clinical suspicion index led to Covid-19 antibody testing (IgG and IgA), which confirmed the diagnosis. The patient was treated with corticosteroids with noticeable clinical improvement. She was discharged to a rehabilitation center. Six months later, the patient was in good general condition, although a neurological deficit was still present. This case indicates the significance of a high clinical suspicion index, based on a combination of clinical manifestations and neuroimaging, and the confirmation of the diagnosis with molecular and antibody testing. Constant awareness of a possible Covid-19 infection among hospitalized patients is mandatory. UMF “Gr. T. Popa” Iasi Publishing House 2023-06-07 /pmc/articles/PMC10246599/ /pubmed/37293685 http://dx.doi.org/10.22551/2023.39.1002.10246 Text en https://creativecommons.org/licenses/by-nc/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Case Report
Symeonidou, Elissavet
Dimitriadou, Androniki
Morsi-Yeroyannis, Antonios
Sidiropoulou, Maria S.
Gkoutziotis, Ioannis
Petras, Panagiotis
Mpallas, Konstantinos
COVID-19 related acute necrotizing encephalopathy presenting in the early postoperative period
title COVID-19 related acute necrotizing encephalopathy presenting in the early postoperative period
title_full COVID-19 related acute necrotizing encephalopathy presenting in the early postoperative period
title_fullStr COVID-19 related acute necrotizing encephalopathy presenting in the early postoperative period
title_full_unstemmed COVID-19 related acute necrotizing encephalopathy presenting in the early postoperative period
title_short COVID-19 related acute necrotizing encephalopathy presenting in the early postoperative period
title_sort covid-19 related acute necrotizing encephalopathy presenting in the early postoperative period
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10246599/
https://www.ncbi.nlm.nih.gov/pubmed/37293685
http://dx.doi.org/10.22551/2023.39.1002.10246
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