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Case Reports
. 2022 Jun 29;14(2):84-86.
doi: 10.4103/jgid.jgid_185_20. eCollection 2022 Apr-Jun.

A Fatal Case Coronavirus Disease 2019 - Associated Acute Hemorrhagic Necrotizing Encephalopathy

Affiliations
Case Reports

A Fatal Case Coronavirus Disease 2019 - Associated Acute Hemorrhagic Necrotizing Encephalopathy

Abdoulahy Diallo et al. J Glob Infect Dis. .

Abstract

Coronavirus disease 2019 (COVID-19) has been reported in association with a variety of brain imaging findings such as acute hemorrhagic necrotizing encephalopathy. To the best of our knowledge, we are reporting a second case of acute necrotizing hemorrhagic encephalopathy associated with COVID-19, which was fatal in a few hours in a 56-year-old male without a specific history. We claim that this case is important because this case shows that the unconscious patients are potentially infected by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and might cause the horizontal infection. In order to end the pandemic of SARS-CoV-2 diseases, the diagnosis of the disease must be prompt and not overlook any findings. We think that diffusion magnetic resonance imaging is a promising and useful sequence to evaluate the changes in brain tissue in the acute necrotizing encephalopathy.

Keywords: Acute hemorrhagic necrotizing encephalopathy; COVID-19; SARS-CoV-2; death.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
Axial CT slices performed after iodine contrast injection and showing bilateral cerebellar lacunae hypodensities with upper vermis hyperdense appearance. At the upper level, a heterogeneous bi-thalamic contrast, taking associated with hydrocephalus is objective CT: Computed tomography
Figure 2
Figure 2
Diffusion MRI axial slices b 1000 with ADC mapping showing bilateral, upper vermin, and bi-thalamic hypersignal beaches b 1000 with signal restriction on ADC mapping in favor of cytotoxic edema. MRI: Magnetic resonance imaging
Figure 3
Figure 3
Axial MRI slices in T2 Gradient Echo, FLAIR, and T1 Spin Echo that show superior and bi-thalamic vermin hemorrhagic lesions. MRI: Magnetic resonance imaging, FLAIR: FLUID-attenuated inversion recovery
Figure 4
Figure 4
MRI slices in the three planes of the T1 FFE space after injection of gadolinium that find heterogeneous contrast intakes of the different lesions with ptosis of the cerebellar tonsils. MRI: Magnetic resonance imaging, FFE: Fast field echo

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