Volume 17, Number 10—October 2011
Dispatch
Pandemic (H1N1) 2009 Encephalitis in Woman, Taiwan
Aristine Cheng, Kuei-Hong Kuo, and Chia-Jui Yang
Table A1
Summary of published case reports for adults (age >18 y) in whom influenza subtype H1N1–related encephalopathy or encephalitis developed*
| Authors, publication year (reference) | Age, y/sex | Ethnicity/nationality | RTI S/S | ILI to CNS, d | Neurologic S/S | Respiratory PCR | CSF PCR | CSF findings | MRI findings | Outcome |
|---|---|---|---|---|---|---|---|---|---|---|
| Akins et al., 2010 (7) | 20/M | Hispanic | RF | 5 | Seizure, coma | Influenza A (H1N1) | No | Mild pleocytosis (leukocyte 53: erythrocyte 6) | Malignant brain edema, with T2-hyperintensities of white matter, symmetric | Mildly disabled (rigidity) |
| Wang et al., 2011 (8) | 22/M | Asian | URI | 3 | Seizure, dysarthria, monoplegia | Influenza A (H1N1) | ND | No pleocytosis (leukocyte 0: erythrocyte 1) | ADEM-like lesion in white matter, symmetric | Full recovery |
| Ito et al., 2011 (9) | 26/M | Asian | URI | 1 | Drowsiness, amnesia, confusion | Influenza A (H1N1) | ND | Mild pleocytosis (leukocyte 38: erythrocyte 3) | ADEM-like lesions in white matter, symmetric | Full recovery |
| Chen et al., 2010 (10) | 40/M | Asian | RF | 2 | Seizure, hemiplegia | Influenza A (H1N1) | ND | Mild pleocytosis (leukocyte 13: erythrocyte NA) | Regional gray matter T2-hyperintensities, asymmetric | Moderately disabled (hemiplegia) |
| Fugate et al., 2010 (11) | 40/M | American | RF | Not clear | Coma, left gaze deviation | Influenza A, not subtyped | ND | Hemorrhagic (leukocyte 1: erythrocyte 157) | Acute hemorrhagic encephalitis, symmetric | Severely disabled (vegetative) |
| This study | 60/F | Asian | URI | 2 | Focal paresthesiae, urinary retention | Influenza A, not subtyped | Yes | Marked pleocytosis (leukocyte 244: erythrocyte 12) | Scattered white and gray matter T2-hyperintensites, asymmetric | Mild residual deficits |
*RTI S/S, respiratory tract infection symptoms and signs; ILI to CNS, interval from influenza-like illness to central nervous system symptoms and signs; respiratory PCR, respiratory tract specimen (e.g., nasopharyngeal swab or broncheoalveolar lavage specimen) real-time PCR for influenza A virus; CSF PCR, cerebrospinal fluid specimen real-time PCR for influenza A virus; MRI, magnetic resonance imaging; RF, respiratory failure; leukocyte:erythrocyte, leukocyte to erythrocyte ratio/mm3; URI, upper respiratory tract infection; ND, not done; ADEM, acute demyelinating encephalomyelitis.
