Late neuropathological findings after acute rubella encephalitis

Neurophathological findings are reported in a 15-year-old boy who died 8 months after acute rubella encephalitis. There are widespread bilateral necroses in large areas of the cerebral cortex with a diffuse macroglial and microglial reaction. In basal ganglia, degenerative changes and a more or less pronounced rarefication of nerve cells as well as very small cystic areas and glial scars are observed. In the white matter, neither foci of demyelination nor perivascular cuffings nor focal gliosis occurred. The results are compared with other observations in the literature. It is concluded that rubells encephalitis is a disease of a variety of pathogenetic mechanisms and has a variety of clinical and morhpological features. It may evidently be caused by direct viral invasion of the CNS or by hypersensitivity reaction.