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Tolosa–Hunt Syndrome and Hemorrhagic Encephalitis Presenting in a Patient after COVID-19 Vaccination Followed by COVID-19 Infection

The presence of neurological symptoms within the clinical range of COVID-19 disease infection has increased. This paper presents the situation of a 45-year-old man having the medical antecedent diabetes mellitus, who presented to the emergency department with fever, headache, and respiratory symptom...

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Autores principales: Gogu, Anca Elena, Motoc, Andrei Gheorghe, Docu Axelerad, Any, Stroe, Alina Zorina, Gogu, Andreea Alexandra, Jianu, Dragos Catalin
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9313130/
https://www.ncbi.nlm.nih.gov/pubmed/35884709
http://dx.doi.org/10.3390/brainsci12070902
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author Gogu, Anca Elena
Motoc, Andrei Gheorghe
Docu Axelerad, Any
Stroe, Alina Zorina
Gogu, Andreea Alexandra
Jianu, Dragos Catalin
author_facet Gogu, Anca Elena
Motoc, Andrei Gheorghe
Docu Axelerad, Any
Stroe, Alina Zorina
Gogu, Andreea Alexandra
Jianu, Dragos Catalin
author_sort Gogu, Anca Elena
collection PubMed
description The presence of neurological symptoms within the clinical range of COVID-19 disease infection has increased. This paper presents the situation of a 45-year-old man having the medical antecedent diabetes mellitus, who presented to the emergency department with fever, headache, and respiratory symptoms, nine days following vaccination with the Ad26.COV2-S COVID-19 vaccine. The patient tested positive for SARS-CoV-2 based on nasal polymerase chain reaction (RT-PCR). Two weeks after the presentation, he developed Tolosa–Hunt Syndrome, an autoimmune phenomenon, with painful left ophthalmoplegia. Significant improvement was seen in terms of his discomfort; however, ptosis and ocular mobility improved only moderately after treatment with intravenous methylprednisolone, and the patient was discharged on a new insulin regimen. The patient returned after four weeks and the neurological exam results showed significant signs of right hemiparesis, mixed aphasia, incomplete left ophthalmoplegia, severe headache, and agitation; after a few days, the patient experienced a depressed level of consciousness and coma. The patient’s clinical condition worsened and, unfortunately, he died. MRI brain images revealed multiple ischemic strokes, meningitis, infectious vasculitis, and hemorrhagic encephalitis, which are all serious complications of COVID-19.
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spelling pubmed-93131302022-07-26 Tolosa–Hunt Syndrome and Hemorrhagic Encephalitis Presenting in a Patient after COVID-19 Vaccination Followed by COVID-19 Infection Gogu, Anca Elena Motoc, Andrei Gheorghe Docu Axelerad, Any Stroe, Alina Zorina Gogu, Andreea Alexandra Jianu, Dragos Catalin Brain Sci Case Report The presence of neurological symptoms within the clinical range of COVID-19 disease infection has increased. This paper presents the situation of a 45-year-old man having the medical antecedent diabetes mellitus, who presented to the emergency department with fever, headache, and respiratory symptoms, nine days following vaccination with the Ad26.COV2-S COVID-19 vaccine. The patient tested positive for SARS-CoV-2 based on nasal polymerase chain reaction (RT-PCR). Two weeks after the presentation, he developed Tolosa–Hunt Syndrome, an autoimmune phenomenon, with painful left ophthalmoplegia. Significant improvement was seen in terms of his discomfort; however, ptosis and ocular mobility improved only moderately after treatment with intravenous methylprednisolone, and the patient was discharged on a new insulin regimen. The patient returned after four weeks and the neurological exam results showed significant signs of right hemiparesis, mixed aphasia, incomplete left ophthalmoplegia, severe headache, and agitation; after a few days, the patient experienced a depressed level of consciousness and coma. The patient’s clinical condition worsened and, unfortunately, he died. MRI brain images revealed multiple ischemic strokes, meningitis, infectious vasculitis, and hemorrhagic encephalitis, which are all serious complications of COVID-19. MDPI 2022-07-10 /pmc/articles/PMC9313130/ /pubmed/35884709 http://dx.doi.org/10.3390/brainsci12070902 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Case Report
Gogu, Anca Elena
Motoc, Andrei Gheorghe
Docu Axelerad, Any
Stroe, Alina Zorina
Gogu, Andreea Alexandra
Jianu, Dragos Catalin
Tolosa–Hunt Syndrome and Hemorrhagic Encephalitis Presenting in a Patient after COVID-19 Vaccination Followed by COVID-19 Infection
title Tolosa–Hunt Syndrome and Hemorrhagic Encephalitis Presenting in a Patient after COVID-19 Vaccination Followed by COVID-19 Infection
title_full Tolosa–Hunt Syndrome and Hemorrhagic Encephalitis Presenting in a Patient after COVID-19 Vaccination Followed by COVID-19 Infection
title_fullStr Tolosa–Hunt Syndrome and Hemorrhagic Encephalitis Presenting in a Patient after COVID-19 Vaccination Followed by COVID-19 Infection
title_full_unstemmed Tolosa–Hunt Syndrome and Hemorrhagic Encephalitis Presenting in a Patient after COVID-19 Vaccination Followed by COVID-19 Infection
title_short Tolosa–Hunt Syndrome and Hemorrhagic Encephalitis Presenting in a Patient after COVID-19 Vaccination Followed by COVID-19 Infection
title_sort tolosa–hunt syndrome and hemorrhagic encephalitis presenting in a patient after covid-19 vaccination followed by covid-19 infection
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9313130/
https://www.ncbi.nlm.nih.gov/pubmed/35884709
http://dx.doi.org/10.3390/brainsci12070902
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