Neuroinvasion of influenza A/H3N2: a fatal case in an immunocompetent adult

J Neurovirol. 2019 Apr;25(2):275-279. doi: 10.1007/s13365-018-0690-9. Epub 2018 Nov 5.

Abstract

Acute necrotizing encephalopathy (ANE) is a severe neurologic complication caused by influenza virus that has been infrequently reported in adult population. The diagnosis is made on epidemiological, clinical, and neuroimaging suspicion, but is rarely confirmed by microbiological findings in samples from the central nervous system (CNS), thus making it difficult to define the mechanism of pathogenesis of influenza-associated encephalitis/encephalopathies (IAE). We report a microbiologically documented case of ANE caused by influenza A/H3N2, in a previously healthy adult patient infected during a flu epidemic in Asturias (Spain). Direct viral invasion of the CNS was demonstrated with the isolation of the virus in a brain biopsy.

Keywords: Acute; Encephalitis; Encephalopathy; Influenza; Necrotizing; Neuroinvasion.

Publication types

  • Case Reports

MeSH terms

  • Acyclovir / therapeutic use
  • Anti-Bacterial Agents / therapeutic use
  • Antiviral Agents / therapeutic use
  • Brain / diagnostic imaging
  • Brain / immunology
  • Brain / pathology
  • Brain / virology
  • Dexamethasone / therapeutic use
  • Encephalitis, Viral / diagnostic imaging
  • Encephalitis, Viral / drug therapy
  • Encephalitis, Viral / pathology*
  • Encephalitis, Viral / virology
  • Fatal Outcome
  • Humans
  • Immunocompetence
  • Influenza A Virus, H3N2 Subtype / growth & development
  • Influenza A Virus, H3N2 Subtype / isolation & purification
  • Influenza A Virus, H3N2 Subtype / pathogenicity*
  • Influenza, Human / diagnostic imaging
  • Influenza, Human / drug therapy
  • Influenza, Human / pathology*
  • Influenza, Human / virology
  • Male
  • Middle Aged
  • Tomography, X-Ray Computed
  • Treatment Failure

Substances

  • Anti-Bacterial Agents
  • Antiviral Agents
  • Dexamethasone
  • Acyclovir