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2017 ; 30
(2
): 164-167
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Acute necrotizing encephalopathy causing human bocavirus
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Ergul AB
; Altug U
; Aydin K
; Guven AS
; Altuner Torun Y
Neuroradiol J
2017[Apr]; 30
(2
): 164-167
PMID28059631
show ga
Acute necrotizing encephalopathy is characterized by multiple, symmetrical
lesions involving the thalamus, brainstem, cerebellum, and white matter and
develops secondarily to viral infections. Influenza viruses are the most common
etiological agents. Here, we present the first case of acute necrotizing
encephalopathy to develop secondarily to human bocavirus. A 3-year-old girl
presented with fever and altered mental status. She had had a fever, cough, and
rhinorrhea for five days. The patient was admitted to the intensive care unit
with an initial diagnosis of encephalitis when vomiting, convulsions, and loss of
consciousness developed. Signs of meningeal irritation were detected upon
physical examination. There was a mild increase in proteins, but no cells, in the
cerebrospinal fluid (CSF). Brain magnetic resonance imaging showed symmetrical,
heterogeneous hyperintensities bilaterally in the caudate nuclei and putamen.
Ammonium, lactate, tandem mass spectroscopy, and urine organic acid were normal.
No bacteria were detected in the CSF cultures. Human bocavirus was detected in a
nasopharyngeal aspirate using real-time PCR, while no influenza was detected.
Oseltamivir, acyclovir, 3% hypertonic saline solution, and supportive care were
used to treat the patient, who was discharged after two weeks. She began to walk
and talk after one month of physical therapy and complete recovery was observed
after six months. Human bocavirus is a recently identified virus that is mainly
reported as a causative agent in respiratory tract infections. Here, we present a
case of influenza-like acute necrotizing encephalopathy secondary to human
bocavirus infection.
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