Fatal case of simply influenza A (H3N2)-associated encephalitis in immunocompetent patient

Clin Neurol Neurosurg. 2021 Nov:210:106956. doi: 10.1016/j.clineuro.2021.106956. Epub 2021 Sep 21.

Abstract

Influenza virus-associated encephalopathy/encephalitis is a rare entity in adults that can lead to severe neurological sequelae and even death. The clinical presentation can be quite diverse. This absence of a typical presentation along with the difficulty detecting the virus in the cerebrospinal fluid represents a diagnostic challenge. We present the case of a 79-year-old male with sudden onset of decreased consciousness and signs of right hemisphere damage. The presence of influenza A (H3N2) virus in respiratory sample along with compatible findings in cranial magnetic resonance led to the diagnosis. The patient died without responding to treatment with antivirals and immunomodulators and the anatomopathological study did not detect infectious agent. Early diagnostic suspicion is essential to establish adequate treatment and improve the prognosis.

Keywords: encephalitis; influenza A H3N2; neurocritical care; neuroinfectious diseases.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Cerebral Cortex / diagnostic imaging*
  • Cerebral Cortex / virology
  • Encephalitis, Viral / diagnostic imaging*
  • Humans
  • Influenza A Virus, H3N2 Subtype / isolation & purification*
  • Influenza, Human / diagnostic imaging*
  • Magnetic Resonance Imaging
  • Male