Department of Rehabilitation, Third Faculty of Medicine, Charles University, Prague, Czech Republic.
National Institute of Mental Health, Klecany, Czech Republic.
Brain Inj. 2024 Apr 15;38(5):331-336. doi: 10.1080/02699052.2024.2311339. Epub 2024 Feb 3.
Delayed encephalopathy after acute carbon monoxide poisoning (DEACMP) is a relatively rare inflammatory-associated neurometabolic complication. In this article, we present a case report of a 50-year-old male patient with a history of carbon monoxide poisoning. This acute poisoning, although successfully controlled during a stay in the intensive care unit of a local hospital, later led to persistent neurological symptoms. The patient was then treated in the inpatient unit of the rehabilitation clinic, where cognitive deterioration began to develop 20 days after admission. Subsequent examination using EEG and magnetic resonance imaging confirmed severe encephalopathy later complicated by SARS-CoV-2 infection with fatal consequences due to bronchopneumonia. Because currently there are no approved guidelines for the management of DEACMP, we briefly discuss the existing challenges for future studies, especially the application of rational immunosuppressive therapy already in the acute treatment phase of CO poisoning, which could prevent the development of a severe form of DEACMP.
急性一氧化碳中毒迟发性脑病（DEACMP）是一种相对罕见的炎症相关神经代谢并发症。本文报告了一例 50 岁男性患者的病例，该患者有一氧化碳中毒史。尽管在当地医院的重症监护病房成功控制了此次急性中毒，但后来仍出现持续的神经症状。随后，该患者在康复科的住院病房接受治疗，入院 20 天后开始出现认知功能恶化。随后使用脑电图和磁共振成像进行检查，最终确诊为严重脑病，后来又并发 SARS-CoV-2 感染，导致因支气管肺炎而死亡。由于目前尚无 DEACMP 管理的既定指南，我们简要讨论了未来研究中存在的挑战，特别是在 CO 中毒的急性治疗阶段应用合理的免疫抑制治疗，这可能预防严重形式的 DEACMP 的发生。
