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Volume 17, Number 10—October 2011
Dispatch

Pandemic (H1N1) 2009 Encephalitis in Woman, Taiwan

Aristine Cheng, Kuei-Hong Kuo, and Chia-Jui YangComments to Author 
Author affiliations: Far Eastern Memorial Hospital, New Taipei City, Taiwan (A. Cheng, K.-H. Kuo, C.-J.Yang); National Taiwan University Hospital and College of Medicine, Taipei, Taiwan (A. Cheng)

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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.

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References
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Page created: September 26, 2011
Page updated: September 26, 2011
Page reviewed: September 26, 2011
The conclusions, findings, and opinions expressed by authors contributing to this journal do not necessarily reflect the official position of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors' affiliated institutions. Use of trade names is for identification only and does not imply endorsement by any of the groups named above.
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