COVID-19–associated Acute Hemorrhagic Necrotizing Encephalopathy: CT and MRI Features
Neo Poyiadji, Gassan Shahin, Daniel Noujaim, Michael Stone, Suresh Patel, and Brent Griffith
Radiology 0 0:0
Since its introduction to the human population in December 2019, the coronavirus disease 2019 (COVID-19) pandemic has spread across the world with over 330,000 reported cases in 190 countries (
1). While patients typically present with fever, shortness of breath, and cough, neurologic manifestations have been reported, although to a much lesser extent (
2). We report the first presumptive case of COVID-19–associated acute necrotizing hemorrhagic encephalopathy, a rare encephalopathy that has been associated with other viral infections but has yet to be demonstrated as a result of COVID-19 infection.
A female airline worker in her late fifties presented with a 3-day history of cough, fever, and altered mental status. Initial laboratory work-up was negative for influenza, with the diagnosis of COVID-19 made by detection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) viral nucleic acid in a nasopharyngeal swab specimen using the U.S. Centers for Disease Control and Prevention (CDC) 2019-Novel Coronavirus (2019-nCoV) Real-Time Reverse Transcriptase-Polymerase Chain Reaction assay. The assay was performed on a Roche thermocycler at our institution following “emergency use authorization” from the CDC. Cerebrospinal fluid (CSF) analysis was limited due to a traumatic lumbar puncture...
