Encephalitis associated with the SARS-CoV-2 virus: a case report

Vandervorst, Fenne; Guldolf, Kaat; Peeters, Ilse; Vanderhasselt, Tim; Michiels, Kathleen; Johanna Berends, Kinge; Van Laethem, Johan; Pipeleers, Lissa; Vincken, Stefanie; Seynaeve, Laura; Engelborghs, Sebastiaan

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) usually causes fever, respiratory symptoms, malaise and myalgia. Recent observations suggested possible neurological complications of COVID-19, including the first report of suspected viral encephalitis. We report a case of a 29-year-old male with -on nasopharyngeal testing- confirmed SARS-CoV-2 infection with severe respiratory symptoms, followed by clinical and radiological signs of encephalitis. Magnetic resonance imaging (MRI) of the brain showed an asymmetric FLAIR-hyperintensity of the left medial temporal cortex associated with mild gyral expansion. Lumbar puncture was normal and PCR’s for SARS-CoV-2 virus on CSF were negative. Clinicians treating SARS-CoV-2 infected patients should be aware of possible neurological complications, like encephalitis. The diagnosis of SARS-CoV-2 encephalitis is difficult as CSF analysis may be normal.