COVID-19-Associated Encephalitis Mimicking Glial Tumor

World Neurosurg. 2020 Aug:140:46-48. doi: 10.1016/j.wneu.2020.05.194. Epub 2020 May 29.

Abstract

Background: Reports on neurologic manifestations of coronavirus disease 2019 (COVID-19) have attracted broad attention. We present an unusual case of COVID-19-associated encephalitis mimicking a glial tumor.

Case description: A 35-year-old woman presented with headache and seizures. T2 fluid-attenuated inverse recovery imaging showed hyperintensities in the left temporal lobe. Magnetic resonance spectroscopy showed an elevated choline peak. Imaging findings were suggestive of high-grade glioma. Antiepileptic medication failed to achieve seizure control. A left anterior temporal lobectomy was performed. The patient had no postoperative deficits, and her symptoms completely improved. Histologic examination revealed encephalitis. Postoperatively, our patient tested positive for COVID-19.

Conclusions: Our case raises awareness of neurologic manifestations of the disease and their potential to mimic glial tumors. For prompt diagnosis and prevention of transmission, clinicians should consider COVID-19 in patients with similar presentation.

Keywords: COVID-19; Coronavirus; Encephalitis; SARS-CoV-2; Spectroscopy.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Betacoronavirus / pathogenicity*
  • COVID-19
  • Coronavirus Infections / complications*
  • Coronavirus Infections / pathology
  • Diagnosis, Differential*
  • Encephalitis / diagnosis
  • Encephalitis / pathology
  • Encephalitis / virology*
  • Female
  • Glioma / diagnosis*
  • Glioma / pathology
  • Headache / virology
  • Humans
  • Pandemics
  • Pneumonia, Viral / complications*
  • Pneumonia, Viral / pathology
  • SARS-CoV-2
  • Seizures / pathology
  • Seizures / virology
  • Temporal Lobe / pathology
  • Temporal Lobe / virology