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Review
. 2017 Aug 7;4(3):ofx145.
doi: 10.1093/ofid/ofx145. eCollection 2017 Summer.

Successful Treatment of Influenza-Associated Acute Necrotizing Encephalitis in an Adult Using High-Dose Oseltamivir and Methylprednisolone: Case Report and Literature Review

Ahmed Alsolami  1 , Kevin Shiley  2
Affiliations
Review

Successful Treatment of Influenza-Associated Acute Necrotizing Encephalitis in an Adult Using High-Dose Oseltamivir and Methylprednisolone: Case Report and Literature Review

Ahmed Alsolami et al. Open Forum Infect Dis. .

Abstract

A case of influenza-associated acute necrotizing encephalitis (ANE) is described in an otherwise healthy adult. The patient was treated successfully with a combination of high-dose methylprednisolone and high-dose oseltamivir. The patient relapsed after discontinuing 150 mg twice daily oseltamivir but quickly improved and eventually recovered after reinitiation of high-dose oseltamivir for an additional 2 weeks. The clinical presentation, pathogenesis, and treatment of influenza-associated ANE is reviewed. The use of high-dose oseltamivir in combination with methylprednisolone may offer additional therapeutic benefit for this rare and poorly understood complication of influenza infection.

Keywords: acute necrotizing encephalitis; encephalitis; encephalopathy; influenza; oseltamivir.

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Figures

Figure 1.
Figure 1.
(A) T1, (B) T2, (C) diffusion weighted imaging, (D) susceptibility weighted imaging. Brain magnetic resonance images showing bilateral symmetrical areas of restricted diffusion and hemorrhagic infarctions within thalami and heads of caudate nuclei, with associated edema.
See this image and copyright information in PMC

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