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Acute influenza virus-associated encephalitis and encephalopathy in adults: a challenging diagnosis
Background: Acute influenza-associated encephalopathy/encephalitis (IAE) in adults is a rare but well-known complication of influenza virus infection. The diagnosis is difficult to make due to the absence of distinctive clinical symptoms and validated diagnostic criteria. We present an illustrative...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Microbiology Society
2016
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5343125/ https://www.ncbi.nlm.nih.gov/pubmed/28348797 http://dx.doi.org/10.1099/jmmcr.0.005076 |
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author | Meijer, Wouter J. Linn, Francisca H. H. Wensing, Anne M. J. Leavis, Helen L. van Riel, Debby GeurtsvanKessel, Corine H. Wattjes, Mike P. Murk, Jean-Luc |
author_facet | Meijer, Wouter J. Linn, Francisca H. H. Wensing, Anne M. J. Leavis, Helen L. van Riel, Debby GeurtsvanKessel, Corine H. Wattjes, Mike P. Murk, Jean-Luc |
author_sort | Meijer, Wouter J. |
collection | PubMed |
description | Background: Acute influenza-associated encephalopathy/encephalitis (IAE) in adults is a rare but well-known complication of influenza virus infection. The diagnosis is difficult to make due to the absence of distinctive clinical symptoms and validated diagnostic criteria. We present an illustrative case and a case review on acute IAE in adults. Methods: We performed a Medline search of the English literature using the terms influenz*, encephal* and adult, and constructed a database of detailed descriptions of patients with influenza virus infection with influenza-like symptoms at the onset of neurological symptoms. Results: A total of 44 patients were included. Confusion and seizures were the most prevalent neurological symptoms, present in 12 (27 %) and 10 (23 %) patients, respectively. Magnetic resonance imaging (MRI) was performed in 21 patients and anomalies were found in 13 (62 %), with lesions located throughout the brain. Influenza virus RNA was detected in cerebrospinal fluid (CSF) in 5 (16 %) of 32 patients. Eight (18 %) of the forty-four patients died. The benefits of antiviral and immunomodulatory therapy have not been well studied. Discussion: Our results show that many different neurological symptoms can be present in patients with acute onset IAE. Therefore, the diagnosis should be considered in patients with fever and neurological symptoms, especially during the influenza season. Laboratory diagnosis consists of demonstration of influenza virus RNA in brain tissue, CSF or respiratory samples, and demonstration of intrathecal antibody production against influenza virus. The presence of brain lesions in MRI and influenza virus in CSF appear to be of prognostic value. |
format | Online Article Text |
id | pubmed-5343125 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2016 |
publisher | Microbiology Society |
record_format | MEDLINE/PubMed |
spelling | pubmed-53431252017-03-27 Acute influenza virus-associated encephalitis and encephalopathy in adults: a challenging diagnosis Meijer, Wouter J. Linn, Francisca H. H. Wensing, Anne M. J. Leavis, Helen L. van Riel, Debby GeurtsvanKessel, Corine H. Wattjes, Mike P. Murk, Jean-Luc JMM Case Rep Case Report Background: Acute influenza-associated encephalopathy/encephalitis (IAE) in adults is a rare but well-known complication of influenza virus infection. The diagnosis is difficult to make due to the absence of distinctive clinical symptoms and validated diagnostic criteria. We present an illustrative case and a case review on acute IAE in adults. Methods: We performed a Medline search of the English literature using the terms influenz*, encephal* and adult, and constructed a database of detailed descriptions of patients with influenza virus infection with influenza-like symptoms at the onset of neurological symptoms. Results: A total of 44 patients were included. Confusion and seizures were the most prevalent neurological symptoms, present in 12 (27 %) and 10 (23 %) patients, respectively. Magnetic resonance imaging (MRI) was performed in 21 patients and anomalies were found in 13 (62 %), with lesions located throughout the brain. Influenza virus RNA was detected in cerebrospinal fluid (CSF) in 5 (16 %) of 32 patients. Eight (18 %) of the forty-four patients died. The benefits of antiviral and immunomodulatory therapy have not been well studied. Discussion: Our results show that many different neurological symptoms can be present in patients with acute onset IAE. Therefore, the diagnosis should be considered in patients with fever and neurological symptoms, especially during the influenza season. Laboratory diagnosis consists of demonstration of influenza virus RNA in brain tissue, CSF or respiratory samples, and demonstration of intrathecal antibody production against influenza virus. The presence of brain lesions in MRI and influenza virus in CSF appear to be of prognostic value. Microbiology Society 2016-12-19 /pmc/articles/PMC5343125/ /pubmed/28348797 http://dx.doi.org/10.1099/jmmcr.0.005076 Text en © 2016 The Authors http://creativecommons.org/licenses/by/4.0/ This is an open access article under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Case Report Meijer, Wouter J. Linn, Francisca H. H. Wensing, Anne M. J. Leavis, Helen L. van Riel, Debby GeurtsvanKessel, Corine H. Wattjes, Mike P. Murk, Jean-Luc Acute influenza virus-associated encephalitis and encephalopathy in adults: a challenging diagnosis |
title | Acute influenza virus-associated encephalitis and encephalopathy in adults: a challenging diagnosis |
title_full | Acute influenza virus-associated encephalitis and encephalopathy in adults: a challenging diagnosis |
title_fullStr | Acute influenza virus-associated encephalitis and encephalopathy in adults: a challenging diagnosis |
title_full_unstemmed | Acute influenza virus-associated encephalitis and encephalopathy in adults: a challenging diagnosis |
title_short | Acute influenza virus-associated encephalitis and encephalopathy in adults: a challenging diagnosis |
title_sort | acute influenza virus-associated encephalitis and encephalopathy in adults: a challenging diagnosis |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5343125/ https://www.ncbi.nlm.nih.gov/pubmed/28348797 http://dx.doi.org/10.1099/jmmcr.0.005076 |
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