Good Outcome With Respect to Acute Necrotizing Encephalitis in Children Associated With Post-infectious SARS-CoV-2

• Published in: CUREUS JOURNAL OF MEDICAL SCIENCE
• Main Authors: Azmi, Anayasmin; Abidin, Anis Siham Zainal
• Format: Article
• Language: English
• Published: SPRINGERNATURE 2023
• Subjects: General & Internal Medicine
• Online Access: https://www-webofscience-com.uitm.idm.oclc.org/wos/woscc/full-record/WOS:001168593900020

This case report demonstrates an excellent outcome in a child with acute necrotizing encephalitis that was likely associated with the post-infectious SARS-CoV-2. The aim of this report is to emphasize that early diagnosis and initiation of immunotherapy treatment may yield good outcome, particularly with the use of tocilizumab and high-dose methylprednisolone. Post immunotherapy, significant neurological improvement was seen through the gradual improvement of Glasgow Coma Scale (GCS) score of 6 to GCS score of 12 within three weeks and subsequently acquired almost full neurological function with minimally dependent activity of daily living (ADL) at eight weeks in the post-treatment follow-up. It is interesting to identify that the possible causative factor could be the natural infection in a vaccinated patient. This was evidenced by the persistently high SARS-CoV-2 immunoglobulin G (IgG)-Spike antibodies titre in a patient vaccinated with two doses of BNT162b2, 11 months before presentation.