Abstract
Introduction: Coronavirus disease 2019 (COVID-19) emerged in December 2019 in China and caused a catastrophic pandemic in 2020. Significant manifestations of COVID-19 are related to the respiratory system; however, other organs, such as the brain and heart, can also be involved.
Case presentation: A 44-year-old-male was hospitalized in our referral emergency center due to being febrile and confused. He experienced five episodes of convulsion in the hospital. Within a day, the respiratory symptoms developed. The polymerase chain reaction of cerebrospinal fluid (CSF) was positive for COVID-19. The analysis of CSF and findings of chest computed tomography scan revealed that the case was infected with meningitis induced by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and pneumonia.
Conclusions: It has been reported that neurological symptoms of COVID-19 can appear earlier than other symptoms. To the best of our knowledge, few articles have represented COVID-induced meningitis. This case study reported the first case of meningitis induced by SARS-CoV-2 in Iran
References
- Sia J. Dizziness can be an early sole clinical manifestation for COVID‐19 infection: a case report. J Am Coll Emerg Physicians Open. 2020;1(6):1354-6. doi: 10.1002/emp2.12185. [PubMed: 32838388].
- World Health Organization. Coronavirus disease (COVID-19). World Health Organization; 2020.
- Wu Y, Xu X, Chen Z, Duan J, Hashimoto K, Yang L, et al. Nervous system involvement after infection with COVID-19 and other coronaviruses. Brain Behav Immun. 2020;87:18-22. doi: 10.1016/j.bbi.2020.03.031. [PubMed: 32240762].
- Packwood R, Galletta G, Tennyson J. An unusual case report of covid-19 presenting with meningitis symptoms and shingles. Clin Pract Cases Emerg Med. 2020;4(3):316-20. doi: 10.5811/cpcem.2020.4.47557. [PubMed: 32926675].
- de Oliveira FA, Palmeira DC, Rocha-Filho PA. Headache and pleocytosis in CSF associated with COVID-19: case report. Neurol Sci. 2020;41(11):3021-2. doi: 10.1007/s10072-020-04694-x. [PubMed: 32875474].
- Arca KN, Starling AJ. Treatment-refractory headache in the setting of COVID-19 pneumonia: migraine or meningoencephalitis? Case report. SN Compr Clin Med. 2020;2(8):1200-3. doi: 10.1007/s42399-020-00369-y. [PubMed: 32838146].
- Moriguchi T, Harii N, Goto J, Harada D, Sugawara H, Takamino J, et al. A first case of meningitis/encephalitis associated with SARS-Coronavirus-2. Int J Infect Dis. 2020;94:55-8. doi: 10.1016/j.ijid.2020.03.062. [PubMed: 32251791].
- Ye M, Ren Y, Lv T. Encephalitis as a clinical manifestation of COVID-19. Brain Behav Immun. 2020;88:945-6. doi: 10.1016/j.bbi.2020.04.017. [PubMed: 32283294].
- Huang YH, Jiang D, Huang JT. SARS-CoV-2 detected in cerebrospinal fluid by PCR in a case of COVID-19 encephalitis. Brain Behav Immun. 2020;87:149. doi: 10.1016/j.bbi.2020.05.012. [PubMed: 32387508].
- Lovati C, Osio M, Pantoni L. Diagnosing herpes simplex-1 encephalitis at the time of COVID-19 pandemic. Neurol Sci. 2020;41(6):1361-4. doi: 10.1007/s10072-020-04461-y. [PubMed: 32405882].