Fatal H1N1-Related Acute Necrotizing Encephalopathy in an Adult
Acute necrotizing encephalopathy (ANE) is a severe neurological complication of influenza infection, including H1N1 influenza. Many cases of ANE have been reported in the pediatric literature, but very few cases have been described in adults. The cause of ANE remains unknown—the influenza virus is n...
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| Format: | Article |
| Language: | English |
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Wiley
2011-01-01
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| Series: | Case Reports in Critical Care |
| Online Access: | http://dx.doi.org/10.1155/2011/562516 |
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| author | Yu-Jin Lee D. Scott Smith Vivek A. Rao Robert D. Siegel Jon Kosek Carol A. Glaser Alexander C. Flint |
| author_facet | Yu-Jin Lee D. Scott Smith Vivek A. Rao Robert D. Siegel Jon Kosek Carol A. Glaser Alexander C. Flint |
| author_sort | Yu-Jin Lee |
| collection | DOAJ |
| description | Acute necrotizing encephalopathy (ANE) is a severe neurological complication of influenza infection, including H1N1 influenza. Many cases of ANE have been reported in the pediatric literature, but very few cases have been described in adults. The cause of ANE remains unknown—the influenza virus is not known to be neurotropic, and evidence of direct viral involvement of the central nervous system (CNS) has not been demonstrated in the limited cases of ANE in which pathological specimens have been obtained. Here we report a fatal case of ANE from H1N1 influenza infection in an adult. Neuroimaging and postmortem analysis both showed widespread brain edema, necrosis, and hemorrhage, but molecular studies and postmortem pathology revealed no evidence of direct viral involvement of the CNS. This case of fatal ANE in an adult is consistent with the hypothesis generated from pediatric cases that the host immune response, and not direct viral invasion of the CNS, is responsible for pathogenesis of ANE. |
| format | Article |
| id | doaj-art-d384c09ead5e4c16948bc3aecb997ffd |
| institution | Kabale University |
| issn | 2090-6420 2090-6439 |
| language | English |
| publishDate | 2011-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Critical Care |
| spelling | doaj-art-d384c09ead5e4c16948bc3aecb997ffd2025-02-03T05:46:45ZengWileyCase Reports in Critical Care2090-64202090-64392011-01-01201110.1155/2011/562516562516Fatal H1N1-Related Acute Necrotizing Encephalopathy in an AdultYu-Jin Lee0D. Scott Smith1Vivek A. Rao2Robert D. Siegel3Jon Kosek4Carol A. Glaser5Alexander C. Flint6Department of Human Biology, Stanford University, Stanford, CA 94305, USADepartment of Infectious Disease and Geographic Medicine, Kaiser Permanente, Redwood City, CA 94063, USADepartment of Neuroscience, Kaiser Permanente, Redwood City, CA 94063, USADepartment of Microbiology and Immunology, Stanford University, Stanford, CA 94305, USADepartment of Pathology, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA 94304, USACenter for Infectious Diseases, California Department of Public Health, Richmond, CA 94804, USADepartment of Neuroscience, Kaiser Permanente, Redwood City, CA 94063, USAAcute necrotizing encephalopathy (ANE) is a severe neurological complication of influenza infection, including H1N1 influenza. Many cases of ANE have been reported in the pediatric literature, but very few cases have been described in adults. The cause of ANE remains unknown—the influenza virus is not known to be neurotropic, and evidence of direct viral involvement of the central nervous system (CNS) has not been demonstrated in the limited cases of ANE in which pathological specimens have been obtained. Here we report a fatal case of ANE from H1N1 influenza infection in an adult. Neuroimaging and postmortem analysis both showed widespread brain edema, necrosis, and hemorrhage, but molecular studies and postmortem pathology revealed no evidence of direct viral involvement of the CNS. This case of fatal ANE in an adult is consistent with the hypothesis generated from pediatric cases that the host immune response, and not direct viral invasion of the CNS, is responsible for pathogenesis of ANE.http://dx.doi.org/10.1155/2011/562516 |
| spellingShingle | Yu-Jin Lee D. Scott Smith Vivek A. Rao Robert D. Siegel Jon Kosek Carol A. Glaser Alexander C. Flint Fatal H1N1-Related Acute Necrotizing Encephalopathy in an Adult Case Reports in Critical Care |
| title | Fatal H1N1-Related Acute Necrotizing Encephalopathy in an Adult |
| title_full | Fatal H1N1-Related Acute Necrotizing Encephalopathy in an Adult |
| title_fullStr | Fatal H1N1-Related Acute Necrotizing Encephalopathy in an Adult |
| title_full_unstemmed | Fatal H1N1-Related Acute Necrotizing Encephalopathy in an Adult |
| title_short | Fatal H1N1-Related Acute Necrotizing Encephalopathy in an Adult |
| title_sort | fatal h1n1 related acute necrotizing encephalopathy in an adult |
| url | http://dx.doi.org/10.1155/2011/562516 |
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