Reis Rúben, Adragão Francisco, Parente Catarina, Nunes Inês, Ramos Armindo, Nabais Inês, Silva Isa
Internal Medicine Department, Centro Hospitalar Barreiro-Montijo, Barreiro, Portugal.
Internal Medicine Department, Centro Hospitalar do Algarve, Algarve, Portugal.
Eur J Case Rep Intern Med. 2021 Feb 24;8(3):002336. doi: 10.12890/2021_002336. eCollection 2021.
Influenza virus infection can have a range of presentations, from asymptomatic to life-threatening disease. We present the case of a 57-year-old woman with a known history of schizophrenia (controlled with medication) who presented to our emergency department in a coma after experiencing a seizure. She had reported flu-like symptoms in the previous week, which evolved to dyspnoea and altered mental status culminating in seizures and coma. Influenza virus A (H3N1) was identified in the cerebrospinal fluid. Although a rare cause of encephalitis, the influenza virus should be considered in the differential diagnosis, especially during epidemics.
Influenza virus encephalitis should be considered in some specific settings, such as during pandemics or seasonal epidemics.Altered mental status in a patient with a history of mental disease may be easily dismissed as secondary to prior disease or medication.Although rare, extrapulmonary manifestations of influenza virus infection can be serious and fatal.
流感病毒感染可表现出一系列症状,从无症状感染到危及生命的疾病。我们报告一例57岁女性病例,该患者有精神分裂症病史(通过药物控制),在经历一次癫痫发作后昏迷被送至我院急诊科。她在前一周报告有流感样症状,随后发展为呼吸困难和精神状态改变,最终导致癫痫发作和昏迷。脑脊液中检测出甲型流感病毒(H3N1)。尽管流感病毒是脑炎的罕见病因,但在鉴别诊断时应予以考虑,尤其是在流行期间。
在一些特定情况下,如大流行或季节性流行期间,应考虑流感病毒脑炎。有精神疾病史的患者出现精神状态改变可能很容易被认为是既往疾病或药物所致的继发性改变。尽管罕见,但流感病毒感染的肺外表现可能很严重且致命。