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- Title
Case report: meningitis as a presenting feature of anti-NMDA receptor encephalitis.
- Authors
Stavrou, Maria; Yeo, Jing Ming; Slater, Alexander David; Koch, Oliver; Irani, Sarosh; Foley, Peter
- Abstract
<bold>Background: </bold>Meningitis is a very rare atypical presenting feature of anti-NMDA receptor encephalitis. In our case report, we describe an unusual clinical presentation of anti-NMDA receptor encephalitis with a biphasic pattern of meningitis followed by encephalitis and discuss potential mechanisms underlying this presentation. We aim to widen the differential diagnosis to be considered in a patient presenting with clinical meningitis and pyrexia.<bold>Case Presentation: </bold>This is a case of a 33-year old Caucasian woman who initially presented with a lymphocytic meningitis attributed to a viral infection. She subsequently developed fluctuating consciousness, agitation, visual hallucinations, dyskinetic movements, a generalized tonic-clonic seizure, and autonomic instability. Investigations revealed a diagnosis of anti-NMDA receptor encephalitis secondary to a previously unidentified ovarian teratoma. She made an excellent recovery with immunotherapy and removal of the teratoma.<bold>Conclusion: </bold>Clinicians should consider autoimmune encephalitides in individuals with meningitis, particularly where extensive investigations fail to identify a causative pathogen and there is rapid development of an encephalitic phenotype.
- Subjects
ANTI-NMDA receptor encephalitis; MENINGITIS; VIRUS diseases; SEIZURES (Medicine); ENCEPHALITIS; OLDER women
- Publication
BMC Infectious Diseases, 2020, Vol 20, Issue 1, p1
- ISSN
1471-2334
- Publication type
journal article
- DOI
10.1186/s12879-020-4761-1