Abstract
Neurological manifestations of SARS-CoV-2 are increasingly being recognised and can arise as a result of direct viral invasion, para-infectious or postinfectious immune mechanisms. We report a delayed presentation of COVID-19 postinfectious immune-mediated encephalitis and status epilepticus occurring in a 47-year-old woman 4 weeks after SARS-CoV-2 pulmonary disease. SARS-CoV-2-specific IgG and IgM antibodies were detected in her cerebrospinal fluid with features of encephalitis evident in both magnetic resonance imaging of the brain and electroencephalogram. She made a complete recovery following treatment with high-dose intravenous corticosteroids and intravenous immunoglobulins. Diagnosis of COVID-19 postinfectious encephalitis may prove challenging in patients presenting many weeks following the initial infection. A high index of clinical suspicion and testing intrathecal SARS-CoV-2-specific antibodies are key to its diagnosis. Early immunotherapy is likely to result in a good outcome.
Keywords: COVID-19; Encephalitis; Postinfectious; SARS-CoV-2.
【저자키워드】 COVID-19, SARS-CoV-2, Encephalitis, Postinfectious, 【초록키워드】 Corticosteroid, Treatment, SARS-CoV-2, Corticosteroids, magnetic resonance imaging, Immunotherapy, immunoglobulins, Infection, Diagnosis, outcome, immune, Brain, Encephalitis, IgM antibodies, Patient, neurological manifestations, mechanisms, cerebrospinal fluid, specific antibodies, Immune-mediated, pulmonary disease, manifestation, Postinfectious, status epilepticus, intravenous, complete recovery, postinfectious encephalitis, High-dose, SARS-CoV-2-specific antibody, IgM antibody, clinical suspicion, SARS-CoV-2-specific IgG, viral invasion, feature, initial, electroencephalogram, presenting, increasingly, 【제목키워드】 SARS-CoV-2, Case report, Delayed,