COVID-19-associated meningoencephalitis in a Brazilian patient: case report and literature review

Silva, Francisco José Cândido da; Farias, Luís Arthur Brasil Gadelha; Holanda, Pablo Eliack Linhares de; Nunes, Fernanda Remígio; Miyajima, Fábio; Damasceno, Lisandra Serra

doi:10.1590/S1678-9946202264014

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Case Report • Rev. Inst. Med. trop. S. Paulo 64 • 2022 • https://doi.org/10.1590/S1678-9946202264014 copy

COVID-19-associated meningoencephalitis in a Brazilian patient: case report and literature review

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

The global pandemic of COVID-19 is caused by the novel coronavirus SARS-CoV-2, which often causes flu-like symptoms and can progress to severe respiratory illness. Thus, as the disease spreads, COVID-19 cases have multiplied across the world, and manifestations involving multiple systems have been described. We report a case of COVID-19-associated meningoencephalitis in a Brazilian male patient who presented with seizures and altered mental status. To the best of our knowledge, this is the first reported case of COVID-19-associated meningoencephalitis in Brazil. COVID-19-associated meningoencephalitis is a rare manifestation of this viral infection and clinicians should be aware of this possible complication.

KEYWORDS:
SARS-CoV-2; COVID-19; Meningoencephalitis; Coronavirus

Authors	Title	Neurological Syndrome	Month/Year ¹ 1 Publication date;	Country	Age	Sex	CSF RT-PCR for SARS-CoV-2	Nasopharyngeal Swab for SARS-CoV-2	Outcome
Moriguchi et al. ⁵5 Moriguchi T, Harii N, Goto J, Harada D, Sugawara H, Takamino J, et al. A first case of meningitis/encephalitis associated with SARS-Coronavirus-2. Int J Infect Dis. 2020;94:55-8.	A first case of meningitis/encephalitis associated with SARS-CoV-2	Meningitis	April/2020	Japan	24 y	M	Positive	Negative	N/A
Packwood et al .¹³13 Packwood R, Galletta G, Tennyson J. An unusual case report of COVID-19 presenting with meningitis symptoms and shingles. Clin Pract Cases Emerg Med. 2020;4:316-20.	Unusual Case Report of COVID-19 presenting with Meningitis symptoms and shingles	Meningitis	August/2020	United States	58 y	M	N/A	Positive	Discharge
Dharsandiya et al .¹⁴14 Dharsandiya M, Shah K, Patel K, Patel T, Patel A, Patel A. SARS-CoV-2 viral sepsis with meningoencephalitis. Indian J Med Microbiol. 2020;38:219-21.	SARS-CoV-2 viral sepsis with meningoencephalitis	Meningoencephalitis	June/2020	India	68 y	M	NP	Positive	Death
Bernard-Valn et al .¹⁵15 Bernard-Valnet R, Pizzarotti B, Anichini A, Demars Y, Russo E, Schmidhauser M, et al. Two patients with acute meningoencephalitis concomitant with SARS-CoV-2 infection. Eur J Neurol. 2020;27:e43-4.	Two patients with acute meningoencephalitis concomitant with SARS-CoV-2 infection	Meningoencephalitis	September/2020	Switzerland	64/67 y	F	Negative	Positive	Discharge ^* * both patients were female, had negative CSF RT-PCR for SARS-CoV-2 , and discharged; m = months; y = years.
Ferreira et al .¹⁶16 Ferreira C, Correa-Roda M. Acute meningoencephalitis as initial presentation of SARS-CoV-2 infection in pediatrics. Pediatr Infect Dis J. 2020;39:e386-7.	Acute meningoencephalitis as initial presentation of SARS-CoV-2 Infection in pediatrics	Meningoencephalitis	November/2020	Colombia	5 m	N/A	Negative	Positive ² 2 Second swab was positive;	Discharge
Dugue et al .¹⁷17 Dugue R, Cay-Martínez KC, Thakur KT, Garcia JA, Chauhan LV, Williams SH, et al. Neurologic manifestations in an infant with COVID-19. Neurology. 2020;94:1100-2.	Neurologic manifestations in an infant with COVID-19	Meningoencephalitis	June/2020	United States	1 m	M	Negative	Positive	Discharge
Regev et al. ¹⁸18 Regev T, Antebi M, Eytan D, Shachor-Meyouhas Y, Ilivitzki A, Aviel YB, et al. Pediatric inflammatory multisystem syndrome with central nervous system involvement and hypocomplementemia following SARS-COV-2 infection. Pediatr Infect Dis J. 2020;39:e206-7.	Pediatric Inflammatory Multisystem Syndrome with Central Nervous System involvement and hypocomplementemia following SARS-CoV-2 infection	Meningoencephalitis	August/2020	Israel	16 y	M	Negative	Positive	Discharge
Al-Olama et al. ¹⁹19 Al-Olama M, Rashid A, Garozzo D. COVID-19-associated meningoencephalitis complicated with intracranial hemorrhage: a case report. Acta Neurochir (Wien). 2020;162:1495-9.	COVID-19-associated meningoencephalitis complicated with intracranial hemorrhage: a case report	Meningoencephalitis	May/2020	United Arab Emirates	36 y	M	Positive ² 2 Second swab was positive;	Positive ² 2 Second swab was positive;	N/A
Chaumont et al. ²⁰20 Chaumont H, Etienne P, Roze E, Couratier C, Roger PM, Lannuzel A. Acute meningoencephalitis in a patient with COVID-19. Rev Neurol (Paris). 2020;176:519-21.	Acute meningoencephalitis in a patient with COVID-19	Meningoencephalitis	June/2020	France	69 y	M	Negative	Positive ³ 3 Performed as bronchoalveolar lavage; M = Male; F = Female; N/A = Not Available; NP=Not performed;	Discharge

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[1] Correspondence to: Francisco José Cândido da Silva Hospital São José de Doenças Infecciosas, Rua Nestor Barbosa, 315, Parquelandia, CEP 60455-610 , Fortaleza, CE, Brazil. E-mail:franciscojose.candido@gmail.com