Anti-NMDAR Encephalitis in Association with Herpes Simplex Virus and Viral and Bacterial Zoonoses

Stefanie Kar Yan Hung1, Fu Liong Hiew1, Shanthi Viswanathan1

  • 1Department of Neurology, Kuala Lumpur Hospital, Jalan Pahang, 50586 Kuala Lumpur, Malaysia.

Insights

Multiple co-infections can trigger autoimmune encephalitis. This study highlights a rare N-methyl-D-aspartate receptor (NMDAR) encephalitis case with multiple co-infections, presenting severe symptoms and treatment resistance.

Area of Science:

  • Neurology
  • Immunology
  • Infectious Diseases

Background:

  • Autoimmune encephalitis, particularly N-methyl-D-aspartate receptor (NMDAR) encephalitis, can be triggered by infections.
  • Co-infections are infrequently reported in patients with NMDAR encephalitis.

Observation:

  • This study reviewed thirty cases of NMDAR encephalitis at a tertiary referral center.
  • Only two cases presented with co-infections.

Findings:

  • One case involved a male patient with multiple co-infections presenting with cortical dysfunction, seizures, and orofacial dyskinesias at onset.
  • This specific case was refractory to initial treatment and occurred in the absence of tumors.

Implications:

  • This case underscores the complex interplay between multiple infections and autoimmune encephalitis.
  • Further research is needed to understand the mechanisms and optimal management of co-infected NMDAR encephalitis patients.

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