[Influenza-associated acute necrotizing encephalitis: unknown makes undertreated?]

Abstract

Background: Influenza-associated acute necrotizing encephalitis (ANE) is a very rare, but severe complication from influenza infection.

Case description: We present a 48 year old male who presented with fever, malaise, confusion and altered mental status (E4M5V2) and influenza A infection. He quickly develops convulsions after which he is intubated and admitted to the Intensive Care Unit following which he remains comatose (E1M1V1). The diagnosis of influenza associated acute necrotizing encephalitis is made based on his neurological symptoms, generalized slowing on electro-encephalogram, classic bilateral findings on MRI in the thalamus and basal ganglia and proven influenza infection in the cerebrospinal fluid.

Conclusion: Acute necrotising encephalitis is a severe complication from a common infection. It is advised to consider early MRI imaging in patients with influenza and fitting neurological symptoms and to consider treatment with corticosteroids.