Volume 23, Number 4—April 2017
CME ACTIVITY - Synopsis
Neurologic Complications of Influenza B Virus Infection in Adults, Romania
Table
Characteristics of 7 patients with neurologic complications of influenza B virus infection, Romania*
Characteristic |
Patient |
||||||
1 |
2 |
3 |
4 |
5 |
6 |
7 |
|
Age,y/sex | 28/F | 37/F | 55/F | 20/F | 57/M | 31/F | 27/F |
Days from illness onset | 3 | 2 | 10 | 5 | 3 | 4 | 3 |
Medical history | Uncontrolled hyperthyroidism | Unremarkable | Influenza A(H3N2) virus encephalitis in 2012 | Treated for Russell−Silver syndrome | Unremarkable | Recent breast implants | Unremarkable |
Leukocyte count, cells/mm3 | 2 | 2 | 10 | 5 | 2 | 3 | 13 |
CSF | |||||||
Protein, g/L | 0.143 | 0.270 | 2.305 | 0.251 | 0.313 | 0.162 | 7.156 |
Glucose, g/L | 0.61 | 0.50 | 0.74 | 1.07 | 0.55 | 0.71 | 1.22 |
Chloride, g/L | ND | ND | 7.60 | 6.78 | 7.10 | 6.80 | 7.02 |
Virus type | B seq EPI_ISL_179707 | B seq EPI_ISL_179711 | B | B | B seq EPI_ISL_182519 | B | B seq EPI_ISL_182518 |
Cerebral imaging result | MRI, abnormal† | CT, normal | MRI, abnormal‡ | MRI, normal | MRI, normal | NA | MRI, abnormal§ |
Diagnosis | Confirmed encephalitis | Possible encephalitis | Confirmed encephalitis | Confirmed encephalitis | Possible encephalitis | Cerebellar ataxia | Confirmed encephalitis |
Length of hospitalization, d | 7 | 9 | 18 | 17 | 10 | 5 | 3 |
Outcome | Died | Complete resolution | Complete resolution | Complete resolution | Complete resolution | Complete resolution | Died |
Clinical findings | Fever, headache, sleepiness, left upper limb motor deficit, coma, GCS score 3–4 | Fever, headache, sleepiness, photophobia, vertigo, stiff neck, positive Romberg sign | Fever, confusion, photophobia, dizziness, right facial paralysis, aphasia, stiff neck, coma, GCS score 8 | Fever, agitation, nystagmus, stiff neck, coma, GCS score 9–10 | Fever, headache, dysarthria, right side motor deficit, vomiting | Fever, headache, vomiting, vertigo, photophobia, ataxia, positive Romberg sign, movement and balance disorder | Fever, headache, vomiting, lethargy, aphasia, upward deviation of eyes, seizures, coma, GCS score 3 |
*All patients showed negative RT-PCR results for influenza B virus in CSF. CSF, cerebrospinal fluid; CT, computed tomography; GCS, Glasgow coma scale; MRI, magnetic resonance imaging; NA, not available; ND, not determined.
†MRI on day 3. See Figure 1 for a detailed description.
‡MRI on day 8. See Figure 2 for a detailed description.
§MRI on day 2 showed multiple areas of hyperintensities.