Case no 3
Patient no 3 is a 38 years old male who presented with complaints of
fever and drowsiness for the last 4 days. He had no significant past
medical history. He was having shortness of breath and chest pain from
the last 12 days. On examination he had a fever of 101.3 F, blood
pressure of 120/75 mm Hg, pulse rate of 96 bpm and respiratory rate of
18/min. He had a GCS 0f 10/15 and was not oriented in time place or
person. He did not show any evidence of neck stiffness or any focal
neurological deficit. His lab and upon suspected encephalitis spinal
fluid was done whose reports are as follows in Table 3.
Autoimmune workup, including anti-N-methyl D-aspartate (NMDA) receptor
antibodies, anti-Ro antibodies, anti-La antibodies, antineutrophil
cytoplasmic antibodies (ANCA) antibodies, and anti-Hu antibodies, were
negative. All common causes of encephalitis were ruled out through these
lab investigations. His chest x ray was done which showed bilateral
opacities and nasal swab COVID-19 Polymerase Chain Reaction (PCR) came
out positive. He was suspected of having COVID-19 encephalitis so CSF
COVID-19 Polymerase Chain Reaction (PCR) was also ordered but it came
back negative. MRI brain was carried out which is given in