Encephalitis/encephalopathy caused by H1N1 Influenza outbreak of 2017-2018 in Qazvin: A case report

In some adults, infections result from influenza, which usually occurs as respiratory infections. In the central nervous system, influenza can cause aseptic meningitis and encephalitis/encephalopathy syndrome that may cause death or persistent brain complications. This report presents a case of encephalitis/encephalopathy caused by H1N1 virus in a 35-year-old man who was hospitalized with reduced consciousness and fever. The patient underwent empirical treatment of meningitis, acyclovir and oseltamivir. In the third day, the patient became alert at the hospital. The RT-PCR was positive for H1N1. In the cerebrospinal fluid sample, ten lymphocytes were seen, but protein and sugar were reported normal, and gram stain and culture were negative. Multiple punctate hyperintensities noted in subcortical white matter (in T2-weighted images of brain MRI) and EEG abnormality reported. Treatment with oseltamivir continued and patient was discharged with good general condition. Decreased level of consciousness can be due to influenza, especially during the epidemic.