Journal article
Case report: meningitis as a presenting feature of anti-NMDA receptor encephalitis
- Abstract:
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BACKGROUND:Meningitis is a very rare atypical presenting feature of anti-NMDA receptor encephalitis. In our case report, we describe an unusual clinical presentation of anti-NMDA receptor encephalitis with a biphasic pattern of meningitis followed by encephalitis and discuss potential mechanisms underlying this presentation. We aim to widen the differential diagnosis to be considered in a patient presenting with clinical meningitis and pyrexia.
CASE PRESENTATION:This is a case of a 33-year old Caucasian woman who initially presented with a lymphocytic meningitis attributed to a viral infection. She subsequently developed fluctuating consciousness, agitation, visual hallucinations, dyskinetic movements, a generalized tonic-clonic seizure, and autonomic instability. Investigations revealed a diagnosis of anti-NMDA receptor encephalitis secondary to a previously unidentified ovarian teratoma. She made an excellent recovery with immunotherapy and removal of the teratoma.
CONCLUSION:Clinicians should consider autoimmune encephalitides in individuals with meningitis, particularly where extensive investigations fail to identify a causative pathogen and there is rapid development of an encephalitic phenotype.
- Publication status:
- Published
- Peer review status:
- Peer reviewed
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(Preview, Version of record, 457.1KB, Terms of use)
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- Publisher copy:
- 10.1186/s12879-020-4761-1
Authors
- Publisher:
- BioMed Central
- Journal:
- BMC Infectious Diseases More from this journal
- Volume:
- 20
- Issue:
- 1
- Article number:
- 21
- Publication date:
- 2020-01-07
- Acceptance date:
- 2019-12-31
- DOI:
- EISSN:
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1471-2334
- ISSN:
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1471-2334
- Pmid:
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31910823
- Language:
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English
- Keywords:
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- Pubs id:
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1081721
- Local pid:
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pubs:1081721
- Deposit date:
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2020-05-30
Terms of use
- Copyright holder:
- Stavrou et al.
- Copyright date:
- 2020
- Rights statement:
- © The Author(s). 2020 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
- Licence:
- CC Attribution (CC BY)
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