Harini Gayithri Lakshman*
Department of Internal Medicine, Hurley Medical Center, USAFulltext PDF
Introduction: SARS-CoV-2 emerged in Wuhan city of China in December 2019 and rapidly spread to more than 200 countries. The respiratory system is the most commonly affected. Many case reports have emerged which show neurological symptoms and signs, although rare neurological symptoms should be expected and treated promptly. We hereby present a relatively rare case of COVID-19 related encephalitis. Case Report: A 21-year-old female with no significant comorbidities, who was tested positive for COVID-19 4 weeks ago and was self-isolating, came to the hospital with H/o high fever of 38.8°C, and altered mental status. She was febrile and delirious in the Emergency Department. Repeat testing of COVID-19 was positive. MRI showed an area of subtle restricted diffusion, Lumbar puncture was done, which was indicative of viral meningitis. Viral panels for all the known viruses that cause meningitis were negative. COVID-19 PCR in CSF could not be sent because of non-availability. EEG showed abnormal slowing with no epileptiform discharges. She was given IV antibiotics, acyclovir and Keppra, after which her mentation improved in 2 days. She was discharged on day 4 after discontinuation of all antimicrobials. Discussion: COVID-19 is majorly known to cause respiratory illness in patients with multiple comorbidities. Nervous system symptoms are uncommon but prevalent. Most of the nervous system signs are from strokes which are secondary to coagulopathies. Encephalitis-like syndromes are very less noted in COVID-19, and even when noted carry bad prognosis. This case is unique for the fact that it is present in a 21 year old with no known co-morbidities and had a quick resolution.
Covid-19; Covid; Corona Virus; Coronavirus disease 2019
Lakshman HG. An Uncommon Presentation of SARS-CoV-2 Infection: A Case Report. Ann Clin Case Rep. 2020; 5: 1858..