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2015 ; 47
(2
): 129-32
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Fever of Unknown Origin: An Unusual Presentation of Anti-N-Methyl-D-Aspartate
Receptor Encephalitis
#MMPMID26157594
Hur J
Infect Chemother
2015[Jun]; 47
(2
): 129-32
PMID26157594
show ga
Encephalitis associated with antibodies to the N-methyl-D-aspartate receptor
(NMDAR) has variable clinical manifestations. Patients are often diagnosed with
infectious processes because of prodromal symptoms and autonomic manifestations.
Approximately 70% of patients have prodromal symptoms consisting of headache,
fever, nausea, vomiting, and diarrhea, along with frequent autonomic
manifestations, including tachycardia, and fluctuating blood pressure. A
36-year-old woman presented with uncontrolled fever and skin and soft tissue
infections. She had shown psychiatric symptoms and abnormal behavior, and had
been diagnosed with bipolar disorder. Antibodies to NMDAR were positive in
cerebrospinal fluid (CSF) and serum samples, and pelvic computed tomography
detected a large ovarian teratoma. The patient improved dramatically after
removal of the teratoma and administration of corticosteroid therapy. When
confronted with a young woman with uncontrolled fever and acute psychiatric
symptoms, physicians should suspect anti-NMDAR encephalitis.