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Acute necrotizing encephalopathy caused by bacterial infection
Shenglan Hu1, Weiqian Yan1,2, Hainan Zhang1,2
1Department of Neurology, The Second Xiangya Hospital, Central South University, 139# Renmin Road, Changsha, Hunan, 410011, China.
BMC Infectious Diseases
|October 6, 2024
Summary
Acute necrotizing encephalopathy (ANE) is a severe brain disorder usually seen in children after viral infections. This case highlights adult ANE caused by a bacterial infection, suggesting immune system involvement.
Area of Science:
- Neurology
- Infectious Diseases
- Immunology
Background:
- Acute necrotizing encephalopathy (ANE) is a rare, severe neurological disorder predominantly affecting children, typically following viral infections.
- Bacterial triggers for ANE are infrequently reported, making its association with bacterial pathogens less understood.
Observation:
- A case of adult-onset ANE following a urinary tract bacterial infection (Escherichia coli) is presented.
- The patient experienced rapid neurological decline into a coma, characterized by a hyperinflammatory state.
- Brain MRI revealed characteristic symmetrical thalamic and pontine lesions with edema, diffusion restriction, and hemorrhage.
Findings:
- Diagnosis of ANE was confirmed based on clinical presentation and distinctive neuroimaging findings.
- The patient received immunotherapy, indicating a potential treatment approach for this condition.
Implications:
- This case expands the known spectrum of pathogens associated with ANE to include bacteria.
- It suggests ANE may represent an immune-mediated response rather than a direct infectious process in the brain.
- Highlights the importance of considering ANE in adults with severe neurological decline post-infection.
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