Acute hepatitis E virus infection presenting as meningo-encephalitis

Area of Science:

• Neurology
• Infectious Diseases
• Hepatology

Background:

• Acute Hepatitis E infection (HEV) is increasingly recognized in Europe.
• HEV should be considered in the differential diagnosis of acute viral hepatitis.
• HEV can present with significant neurological manifestations.

Purpose of the Study:

• To report a case of HEV infection with pronounced neurological symptoms.
• To highlight the importance of considering HEV in patients with unexplained neurological and hepatic dysfunction.
• To discuss the diagnostic and therapeutic approach for HEV-induced neurological complications.

Main Methods:

• Case report of a 33-year-old female patient with arthralgia, myalgia, headache, and psychomotor deterioration.
• Laboratory analysis including liver enzymes and cerebrospinal fluid (CSF) examination.
• Detection of HEV RNA in serum and CSF.
• Treatment with intravenous corticosteroids.

Main Results:

• The patient presented with elevated transaminases and neurological symptoms.
• HEV infection was confirmed serologically and by viral RNA detection in CSF.
• Neurological symptoms, including dysesthesias, persisted despite initial management.
• Intravenous corticosteroid therapy led to complete and sustained remission.

Conclusions:

• HEV infection should be suspected in patients with acute neurological symptoms and elevated liver enzymes.
• Neurological manifestations such as fatigue, arthralgia, myalgia, dysesthesia, and psychomotor retardation warrant further investigation, including CSF analysis.
• Corticosteroid treatment may be effective in managing severe neurological complications of HEV infection.