Human Metapneumovirus in the Cerebrospinal Fluid of a Patient With Acute Encephalitis.
OBJECTIVE
To report, to our knowledge, the first case of detection of human metapneumovirus in the cerebrospinal fluid of a patient during acute encephalitis.


METHODS
Case report.


METHODS
University hospital.


METHODS
A 10-year-old girl with acute encephalitis.


RESULTS
Human metapneumovirus was detected in cerebrospinal fluid and nasal-wash specimens during the initial phase of mild encephalitis. Abrupt clinical deterioration was associated with the presence of multiple areas of demyelination and cortical abnormalities. Demyelinated areas improved after immunomodulatory therapy, but cortical lesions spread in both hemispheres. Surprisingly, clinical worsening occurred when the virus became undetectable in cerebrospinal fluid.


CONCLUSIONS
The detection of human metapneumovirus in cerebrospinal fluid strongly suggests its causative role in acute encephalitis. The evolution of the clinical and radiological features provided insight into the pathogenesis of human metapneumovirus encephalitis.
Department of Child Neurology, Hospital Sant Joan de Déu, Barcelona, Spain. ivan.sanchezfernandez@yahoo.es
Iván
I
Sánchez Fernández
Mónica
M
Rebollo Polo
Carmen
C
Muñoz-Almagro
Laura
L
Monfort Carretero
Sergio
S
Fernández Ureña
Adela
A
Rueda Muñoz
Roser
R
Colomé Roura
Belén
B
Pérez Dueñas
D000208:Acute Disease; D000914:Antibodies, Viral / Q000134:cerebrospinal fluid*; D002540:Cerebral Cortex / Q000473:pathology / Q000821:virology; D002648:Child; D004660:Encephalitis / Q000134:cerebrospinal fluid* / Q000150:complications / Q000821:virology*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D029121:Metapneumovirus / Q000472:pathogenicity*; D018184:Paramyxoviridae Infections / Q000150:complications
D000914:Antibodies, Viral