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.
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Acknowledgements
We thank Dr. María Isabel Blanco Costa, from the Microbiology Department at the Hospital Comarcal de Jarrio, for sharing microbiological results with us; the Radiology Department at Hospital Comarcal de Jarrio for providing brain computed tomography images; and professor Ronnie Ladrum for helping with English translation of this case report.
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Ana Fernández-Blázquez and María Castañón-Apilánez are dual first authorship
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Fernández-Blázquez, A., Castañón-Apilánez, M., Álvarez-Argüelles, M.E. et al. Neuroinvasion of influenza A/H3N2: a fatal case in an immunocompetent adult. J. Neurovirol. 25, 275–279 (2019). https://doi.org/10.1007/s13365-018-0690-9
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DOI: https://doi.org/10.1007/s13365-018-0690-9