Rapidly progressive acute necrotizing encephalopathy associated with influenza A in an elderly adult.

Rapidly progressive acute necrotizing encephalopathy associated with influenza A in an elderly adult.
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DOI:
10.1002/ams2.611
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发表时间:
2020-01
影响因子:
1.6
通讯作者:
Hattori T
Hattori T
中科院分区:
其他
文献类型:
--
作者:
Tsubota M;Kato A;Goshima T;Imai K;Yamagishi Y;Matsushima A;Sasano H;Hattori T

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我们遇到一位急性坏死性脑病的病人,他与甲型流感有关,在10分钟内从清醒状态陷入昏迷。 在流感相关脑病中,急性坏死性脑病(ANE)的预后特别差。虽然它通常在48小时内进展,但我们遇到了一个快速发展的病例,患者在10分钟内从清醒状态陷入昏迷。一名71岁的男子在洗澡10分钟后被发现失去知觉,并被送往急诊室。头部计算机断层扫描(HCT)正常,他被诊断为A型流感并发症中暑。尽管对他进行了有效的治疗以纠正体温,但他的意识没有改善,在24小时内他进展为多器官损伤。重复HCT和随后的磁共振成像显示不可挽回的进展ANE。为了有效治疗ANE,早期识别和诊断至关重要。我们的病例表明,ANE应被考虑并添加到快速认知功能恶化的成人患者的鉴别诊断中。
We encountered a patient with rapidly progressive acute necrotizing encephalopathy associated with influenza A falling into coma from lucidity within 10 min. Among the influenza‐associated encephalopathies, acute necrotizing encephalopathy (ANE) has a particularly poor prognosis. While it usually progresses within 48 h, we encountered a rapidly evolving case with the patient falling into coma from lucidity within 10 min. A 71‐year‐old man was found unconscious after taking a 10‐min bath and brought to the emergency room. The head computed tomography (HCT) was normal, and he was diagnosed with heatstroke as a complication of influenza A. Despite effective therapy to correct his temperature, his consciousness did not improve, and within 24 h he progressed to multiple organ injury. Repeat HCT and subsequent magnetic resonance imaging revealed irreparably progressed ANE. To effectively treat ANE, early recognition and diagnosis are critical. Our case suggests that ANE should be considered and added to the differential diagnosis for adult patients with rapid cognitive deterioration.
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