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COVID-19-associated leukoencephalopathy in the absence of severe hypoxia with subsequent improvement: a case report
BACKGROUND: Several cases of coronavirus disease 2019 (COVID-19)-associated leukoencephalopathy have been reported. Although most cases involve hypoxia, the pathophysiological mechanism and neurologic outcomes of COVID-19-associated leukoencephalopathy remain unclear. CASE PRESENTATION: We report a...
Autores principales: | , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9086412/ https://www.ncbi.nlm.nih.gov/pubmed/35538434 http://dx.doi.org/10.1186/s12879-022-07426-y |
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author | Kojima, Hiroki Sakamoto, Naoya Kosaka, Atsushi Kobayashi, Masayoshi Amemiya, Mitsuo Washino, Takuya Kuwahara, Yusuke Ishida, Takuto Hikone, Mayu Miike, Satoshi Oyabu, Tatsunori Iwabuchi, Sentaro Nakamura-Uchiyama, Fukumi |
author_facet | Kojima, Hiroki Sakamoto, Naoya Kosaka, Atsushi Kobayashi, Masayoshi Amemiya, Mitsuo Washino, Takuya Kuwahara, Yusuke Ishida, Takuto Hikone, Mayu Miike, Satoshi Oyabu, Tatsunori Iwabuchi, Sentaro Nakamura-Uchiyama, Fukumi |
author_sort | Kojima, Hiroki |
collection | PubMed |
description | BACKGROUND: Several cases of coronavirus disease 2019 (COVID-19)-associated leukoencephalopathy have been reported. Although most cases involve hypoxia, the pathophysiological mechanism and neurologic outcomes of COVID-19-associated leukoencephalopathy remain unclear. CASE PRESENTATION: We report a case of COVID-19-associated leukoencephalopathy without severe hypoxia in a 65-year-old woman diagnosed with pyelonephritis. After the initiation of intravenous ceftriaxone, her fever resolved, but she developed an altered state of consciousness with abnormal behavior and, subsequently, a relapse fever. She was diagnosed with COVID-19 pneumonia and was intubated. Lung-protective ventilation with deep sedation and neuromuscular blockade were used for treatment. After cessation of sedative administration, her mental status remained at a Glasgow Coma Scale score of 3. COVID-19 was assumed to have caused leukoencephalopathy due to the absence of severe hypoxia or other potential causes. She subsequently showed gradual neurologic improvement. Three months after the COVID-19 diagnosis, she regained alertness, with a Glasgow Coma Scale score of 15. CONCLUSION: Clinicians should consider leukoencephalopathy in the differential diagnosis of consciousness disorders in patients with severe COVID-19, even in the absence of severe hypoxia. Gradual neurologic improvement can be expected in such cases. |
format | Online Article Text |
id | pubmed-9086412 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-90864122022-05-10 COVID-19-associated leukoencephalopathy in the absence of severe hypoxia with subsequent improvement: a case report Kojima, Hiroki Sakamoto, Naoya Kosaka, Atsushi Kobayashi, Masayoshi Amemiya, Mitsuo Washino, Takuya Kuwahara, Yusuke Ishida, Takuto Hikone, Mayu Miike, Satoshi Oyabu, Tatsunori Iwabuchi, Sentaro Nakamura-Uchiyama, Fukumi BMC Infect Dis Case Report BACKGROUND: Several cases of coronavirus disease 2019 (COVID-19)-associated leukoencephalopathy have been reported. Although most cases involve hypoxia, the pathophysiological mechanism and neurologic outcomes of COVID-19-associated leukoencephalopathy remain unclear. CASE PRESENTATION: We report a case of COVID-19-associated leukoencephalopathy without severe hypoxia in a 65-year-old woman diagnosed with pyelonephritis. After the initiation of intravenous ceftriaxone, her fever resolved, but she developed an altered state of consciousness with abnormal behavior and, subsequently, a relapse fever. She was diagnosed with COVID-19 pneumonia and was intubated. Lung-protective ventilation with deep sedation and neuromuscular blockade were used for treatment. After cessation of sedative administration, her mental status remained at a Glasgow Coma Scale score of 3. COVID-19 was assumed to have caused leukoencephalopathy due to the absence of severe hypoxia or other potential causes. She subsequently showed gradual neurologic improvement. Three months after the COVID-19 diagnosis, she regained alertness, with a Glasgow Coma Scale score of 15. CONCLUSION: Clinicians should consider leukoencephalopathy in the differential diagnosis of consciousness disorders in patients with severe COVID-19, even in the absence of severe hypoxia. Gradual neurologic improvement can be expected in such cases. BioMed Central 2022-05-10 /pmc/articles/PMC9086412/ /pubmed/35538434 http://dx.doi.org/10.1186/s12879-022-07426-y Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Case Report Kojima, Hiroki Sakamoto, Naoya Kosaka, Atsushi Kobayashi, Masayoshi Amemiya, Mitsuo Washino, Takuya Kuwahara, Yusuke Ishida, Takuto Hikone, Mayu Miike, Satoshi Oyabu, Tatsunori Iwabuchi, Sentaro Nakamura-Uchiyama, Fukumi COVID-19-associated leukoencephalopathy in the absence of severe hypoxia with subsequent improvement: a case report |
title | COVID-19-associated leukoencephalopathy in the absence of severe hypoxia with subsequent improvement: a case report |
title_full | COVID-19-associated leukoencephalopathy in the absence of severe hypoxia with subsequent improvement: a case report |
title_fullStr | COVID-19-associated leukoencephalopathy in the absence of severe hypoxia with subsequent improvement: a case report |
title_full_unstemmed | COVID-19-associated leukoencephalopathy in the absence of severe hypoxia with subsequent improvement: a case report |
title_short | COVID-19-associated leukoencephalopathy in the absence of severe hypoxia with subsequent improvement: a case report |
title_sort | covid-19-associated leukoencephalopathy in the absence of severe hypoxia with subsequent improvement: a case report |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9086412/ https://www.ncbi.nlm.nih.gov/pubmed/35538434 http://dx.doi.org/10.1186/s12879-022-07426-y |
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