Mild encephalopathy with reversible splenium lesion (MERS) in a patient with COVID-19

ABSTRACT: Highlights • MERS is characterized by fever, encephalopathy, and a reversible splenium lesion.• MERS has been associated with infection, potentially as an autoimmune response.• MERS has not previously been described in conjunction with COVID-19.• We present the first reported case of MERS in the setting of SARS-CoV-2 antibodies. Neurological complications of coronavirus 2019 (COVID-19) are common, and novel manifestations are increasingly being recognized. Mild encephalopathy with reversible splenium lesion (MERS) is a syndrome that has been associated with viral infections, but not previously with COVID-19. In this report, we describe the case of a 69 year-old man who presented with fever and encephalopathy in the setting of a diffusion-restricting splenium lesion, initially mimicking an ischemic stroke. A comprehensive infectious workup revealed positive severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antibodies, and a pro-inflammatory laboratory profile characteristic of COVID-19 infection. His symptoms resolved and the brain MRI findings completely normalized on repeat imaging, consistent with MERS. This case suggests that MERS may manifest as an autoimmune response to SARS-CoV-2 infection and should be considered in a patient with evidence of recent COVID-19 infection and the characteristic MERS clinico-radiological syndrome.

SUBMITTER: Kakadia B 

PROVIDER: S-EPMC7340073 | biostudies-literature | 2020 Jul

REPOSITORIES: biostudies-literature