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A frantic confusion: beyond rabies and anti-N-methyl-D-aspartate encephalitis

Adrien Cottu1,2, Aïcha Kante3,4, Alexandre Megherbi3,4

  • 1Service de Réanimation Médicale, Centre Hospitalo-Universitaire Robert Ballanger, Aulnay-Sous-Bois, France. adriencottu@orange.fr.

Journal of Neurovirology
|May 12, 2023
PubMed

Insights

Hepatitis E virus (HEV) can cause meningoencephalitis, a rare neurological condition. This case highlights a favorable outcome in an immunocompetent adult, suggesting HEV is an under-recognized cause of brain inflammation.

Area of Science:

  • Neurology
  • Infectious Diseases
  • Hepatology

Background:

  • Hepatitis E virus (HEV) is a significant global cause of acute hepatitis.
  • Neurological complications, including meningoencephalitis, are rare but recognized manifestations of HEV infection.
  • Previous reports document limited cases of HEV-associated meningoencephalitis over two decades.

Observation:

  • A 44-year-old immunocompetent adult presented with HEV meningoencephalitis.
  • Initial symptoms included behavioral changes (aggressiveness) progressing to coma.
  • The patient experienced a spontaneous, favorable recovery without specific antiviral or neurological treatment.

Findings:

  • This case adds to the limited literature on Hepatitis E virus-induced meningoencephalitis.
  • The clinical presentation varied, underscoring the diverse neurological sequelae of HEV.
  • Most affected individuals, particularly immunocompetent adults, exhibit spontaneous recovery.

Implications:

  • HEV should be considered in the differential diagnosis of meningoencephalitis, especially in endemic areas.
  • Increased awareness may lead to better recognition of this under-diagnosed neurological complication.
  • Further research is warranted to understand the pathogenesis and long-term outcomes of HEV meningoencephalitis.
Keywords:
ComaHEVHepatitisImmunocompetentMeningoencephalitis

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