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Published on: December 2, 2012
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Indirect Confirmation of a COVID-19 Encephalitis Case
Kleoniki Georgousi1, Panagiotis Karageorgiou2, Maria Tzaki2
1Internal Medicine/Infectious Diseases, KAT Attica General Hospital, Kifissia, GRC.
Cureus
|May 3, 2023
Summary
This case report highlights that detecting cerebrospinal fluid (CSF) immunoglobulin A (IgA) and IgG antibodies can diagnose encephalitis in COVID-19 patients, confirming central nervous system (CNS) infection.
Area of Science:
- Neurology
- Infectious Diseases
- Immunology
Background:
- COVID-19 can present with diverse neurological complications, including encephalitis.
- Diagnosing central nervous system (CNS) involvement in COVID-19 can be challenging, especially with negative SARS-CoV-2 PCR in cerebrospinal fluid (CSF).
Observation:
- A 58-year-old man developed acute encephalitis with altered mental status and aggressive behavior 15 days post-COVID-19 infection.
- Initial investigations including brain imaging and CSF PCR for SARS-CoV-2 were unremarkable.
- New onset myoclonic jerks appeared during hospitalization, responding to levetiracetam.
Findings:
- Elevated CSF immunoglobulin A (IgA) and IgG antibody concentrations suggested indirect confirmation of SARS-CoV-2 neuroinvasion.
- Autoimmune encephalitis was ruled out due to the absence of known autoantibodies.
- Antiviral and corticosteroid therapy led to full recovery.
Implications:
- CSF IgA and IgG antibody detection is crucial for diagnosing encephalitis in COVID-19 patients.
- This diagnostic approach aids in confirming CNS infection even with negative viral PCR.
- Early diagnosis and treatment are vital for favorable outcomes in COVID-19-associated neurological complications.
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