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. 2003 Mar 1;36(5):567-74.
doi: 10.1086/367623. Epub 2003 Feb 14.

Acute encephalopathy associated with influenza A virus infection

Christoph Steininger  1 , Theresia Popow-Kraupp, Hermann Laferl, Andreas Seiser, Irene Gödl, Schiva Djamshidian, Elisabeth Puchhammer-Stöckl
Affiliations

Acute encephalopathy associated with influenza A virus infection

Christoph Steininger et al. Clin Infect Dis. .

Abstract

Twenty-one patients aged 4-78 years with influenza A virus-associated acute encephalopathy were studied. Influenza A virus could be detected only in a cerebrospinal fluid (CSF) specimen obtained from 1 of 18 patients, despite the use of a highly sensitive polymerase chain reaction assay. Six patients experienced influenzal encephalopathy during the course of respiratory illness. Five of these patients had hypoprothrombinemia and 4 had increased serum creatinine levels, indicating hepatic and/or renal dysfunction. Fourteen patients experienced postinfluenzal encephalopathy <or=3 weeks after resolution of acute respiratory symptoms. In 6 patients, focal areas of high signal intensity were visible on T2-weighted magnetic resonance images of the brain. Adenovirus DNA was detected in CSF specimens obtained from 4 (36%) of 11 patients with postinfluenzal encephalopathy. Thus, influenzal encephalopathy is frequently associated with metabolic disorders, whereas postinfluenzal encephalopathy appears to have different possible etiologies.

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Figures

Figure 1
Figure 1
A and B, Single, large, tumorlike lesion of the brain (arrows) associated with cerebral edema in a 23-year-old patient with postinfluenzal encephalopathy noted on T2-weighted MRIs. Adenovirus DNA was detected in a CSF sample obtained from this patient 1 day earlier. C and D, MRIs for this patient 2 months later that reveal regression of this single lesion (arrow) but also an additional lesion (arrowhead).
Figure 2
Figure 2
Comparison of selected laboratory parameters for patients with influenzal or postinfluenzal encephalopathy.
See this image and copyright information in PMC

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