Myeloencephalitis as the only presentation of Omicron SARS-CoV-2 infection

BMJ Case Rep. 2022 Nov 15;15(11):e251922. doi: 10.1136/bcr-2022-251922.

Abstract

SARS-CoV-2 is now a major global health issue and manifests mainly as a respiratory disorder. Several other complications involving hypercoagulability, cardiovascular system and central nervous system have been described in the literature. Among these atypical presentations, encephalopathy associated with SARS-CoV-2 is a rare entity with heterogenous clinical and radiological findings. The direct presence of SARS-CoV-2 in cerebrospinal fluid (CSF) was rarely found in encephalopathy patients with acute SARS-Cov-2 infection.Here, we report a case of myeloencephalitis with positive real-time PCR for SARS-CoV-2 in CSF in a young woman presenting exclusively with neurological symptoms. Other differential diagnosis were extensively pursued by a comprehensive aetiological workup. To our knowledge, this is the first case report in the Omicron era. In the context of recent global explosion of SARS-Cov-2 infections, clinicians should consider this pathogen among other possible neurotropic agents and be familiar with its radiological and clinical presentations.

Keywords: COVID-19; Infection (neurology).

Publication types

  • Case Reports

MeSH terms

  • Brain Diseases / virology
  • COVID-19* / complications
  • Encephalomyelitis* / diagnosis
  • Encephalomyelitis* / virology
  • Female
  • Humans
  • Real-Time Polymerase Chain Reaction
  • SARS-CoV-2 / genetics
  • SARS-CoV-2 / isolation & purification