Infectious diseases (London, England) · 2021
Psychosis associated with suspected SARS-CoV-2 encephalitis with response to steroids: a case report.
Клинический случайСтатьяНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Ariza-Varón Michael, Beltrán María Alejandra, Marín-Medina Daniel S, González Andrés Felipe, Ávila Ana Milena
Аннотация
INTRODUCTION: The SARS-Cov-2 infection has multiple neurologic manifestations including encephalitis in multiple cases reported, however the psychosis as principal manifestation of this condition is infrequently.
CASE REPORT: We report the case of a 48-year-old woman with a confirmed diagnosis of SARS-CoV-2 who developed paranoid and self-referential ideas with behavioural alteration and multiple findings on mental examination. Encephalitis associated with Covid-19 was suspected due to the neurological clinical presentation (persistent despite resolve hypoxaemia and systemic symptoms) and brain magnetic resonance image (MRI) that showed asymmetric hippocampal hyperintensities, although cerebrospinal fluid and electroencephalogram (EEG) were normal. The patient received medical treatment with methylprednisolone for 5 days with complete resolution of her symptoms.
DISCUSSION: The current SARS-CoV-2 pandemic has neurological complications either by direct involvement or by para-infectious or post-infectious phenomena. Encephalitis occurs in a small proportion of the cases, while psychiatric symptoms have been described in a variable percentage of the events. However, a psychotic picture such as the one reported in our case is unusual. MRI, cerebrospinal fluid and EEG are important for the diagnostic evaluation of these patients but not obligatory to the diagnosis. The treatment of this condition with corticosteroids has been successful even in cases associated with Anti-NMDA. Our case is the second reported in Colombia, the first to be associated with psychosis.
CASE REPORT: We report the case of a 48-year-old woman with a confirmed diagnosis of SARS-CoV-2 who developed paranoid and self-referential ideas with behavioural alteration and multiple findings on mental examination. Encephalitis associated with Covid-19 was suspected due to the neurological clinical presentation (persistent despite resolve hypoxaemia and systemic symptoms) and brain magnetic resonance image (MRI) that showed asymmetric hippocampal hyperintensities, although cerebrospinal fluid and electroencephalogram (EEG) were normal. The patient received medical treatment with methylprednisolone for 5 days with complete resolution of her symptoms.
DISCUSSION: The current SARS-CoV-2 pandemic has neurological complications either by direct involvement or by para-infectious or post-infectious phenomena. Encephalitis occurs in a small proportion of the cases, while psychiatric symptoms have been described in a variable percentage of the events. However, a psychotic picture such as the one reported in our case is unusual. MRI, cerebrospinal fluid and EEG are important for the diagnostic evaluation of these patients but not obligatory to the diagnosis. The treatment of this condition with corticosteroids has been successful even in cases associated with Anti-NMDA. Our case is the second reported in Colombia, the first to be associated with psychosis.