Elderly-onset acute necrotizing encephalopathy mimicking severe heat stroke: a case report and review of the literature.
Bilateral symmetrical thalamic lesions
hyperthermia
influenza‐associated encephalopathy
Journal
Acute medicine & surgery
ISSN: 2052-8817
Titre abrégé: Acute Med Surg
Pays: United States
ID NLM: 101635464
Informations de publication
Date de publication:
Jul 2019
Jul 2019
Historique:
received:
15
07
2018
accepted:
16
03
2019
entrez:
16
7
2019
pubmed:
16
7
2019
medline:
16
7
2019
Statut:
epublish
Résumé
Acute necrotizing encephalopathy (ANE), known as influenza-associated encephalitis, typically affects children. A 70-year-old woman was admitted to the hospital with altered consciousness, a high temperature, and severe hypotension. Computed tomography (CT) of the head showed no abnormalities; thus, a diagnosis of suspected severe heat stroke was made. On day 2, repeated head CT revealed bilateral symmetrical lesions to the thalamus, and a rapid influenza antigen test was positive. Based on the CT findings and the medical history of influenza, a differential diagnosis of ANE was made. Subsequently, brain edema spread across the whole brain, and the patient died on day 21. In elderly patients, differentiating ANE from severe heat stroke in a high-temperature environment is difficult because of the similarities in clinical symptoms due to multiple organ failure.
Sections du résumé
BACKGROUND
BACKGROUND
Acute necrotizing encephalopathy (ANE), known as influenza-associated encephalitis, typically affects children.
CASE PRESENTATION
METHODS
A 70-year-old woman was admitted to the hospital with altered consciousness, a high temperature, and severe hypotension. Computed tomography (CT) of the head showed no abnormalities; thus, a diagnosis of suspected severe heat stroke was made. On day 2, repeated head CT revealed bilateral symmetrical lesions to the thalamus, and a rapid influenza antigen test was positive. Based on the CT findings and the medical history of influenza, a differential diagnosis of ANE was made. Subsequently, brain edema spread across the whole brain, and the patient died on day 21.
CONCLUSION
CONCLUSIONS
In elderly patients, differentiating ANE from severe heat stroke in a high-temperature environment is difficult because of the similarities in clinical symptoms due to multiple organ failure.
Identifiants
pubmed: 31304037
doi: 10.1002/ams2.418
pii: AMS2418
pmc: PMC6603324
doi:
Types de publication
Case Reports
Langues
eng
Pagination
316-320Références
Rinsho Shinkeigaku. 2000 Aug;40(8):827-31
pubmed: 11218705
No To Shinkei. 2002 Apr;54(4):354-5
pubmed: 11993167
Neuroradiology. 2002 Jun;44(6):489-93
pubmed: 12070722
J Neuroimaging. 2002 Jul;12(3):273-5
pubmed: 12116748
No To Shinkei. 2006 Nov;58(11):1009-14
pubmed: 17134009
J Neurol. 2007 Aug;254(8):1135-7
pubmed: 17294066
J Neurol Neurosurg Psychiatry. 2008 Feb;79(2):227-8
pubmed: 17846107
Brain Dev. 2009 Mar;31(3):221-7
pubmed: 18456443
J Neurol. 2013 Jun;260(6):1545-53
pubmed: 23329376
Intern Med. 2013;52(3):377-80
pubmed: 23370749
J Neuroinflammation. 2013 Oct 18;10:128
pubmed: 24139226
Case Rep Crit Care. 2011;2011:562516
pubmed: 24826323
Ann Saudi Med. 2014 Sep-Oct;34(5):451-2
pubmed: 25827707
J Clin Imaging Sci. 2015 Apr 30;5:20
pubmed: 25973284
J Neurol Sci. 2015 Jul 15;354(1-2):129-30
pubmed: 25982501
Acta Neuropathol. 1989;78(1):108-11
pubmed: 2735185
Open Forum Infect Dis. 2017 Aug 07;4(3):ofx145
pubmed: 28852683
Ther Clin Risk Manag. 2018 Apr 20;14:753-756
pubmed: 29720877
Neurology. 2018 Jul 31;91(5):e490-e491
pubmed: 30061348
Intern Med. 2019 Jan 1;58(1):53-62
pubmed: 30146565
J Neurol Neurosurg Psychiatry. 1995 May;58(5):555-61
pubmed: 7745402
Brain Dev. 1997 Mar;19(2):81-92
pubmed: 9105653