title: [An adult case of influenza-associated encephalitis successfully treated with high dose intravenous immunoglobulins].
abstract: A 73-year-old man was admitted to our hospital with a high fever and left paresis. A rapid diagnosis test was positive for influenza A was positive by rapid diagnosis test and diffusion-weighted MRI imaging of the brain showed a high intensity lesion of the right cerebral peduncle. The patient was therefore diagnosed as having influenza A virus infection complicated with lacunar infarction. In spite of initial treatment with oseltamivir and anticoagulant therapy, he lost consciousness eight hours after admission. The high intensity lesion of the cerebral peduncle enlarged and new lesions in the thalamus, hippocampus and calcarine cortex were detected with brain MRI. Additionally, an electroencephalographic study showed an entire slow wave and as the other causative pathogens of central nerve system infection were not detected, the likely diagnosis was influenza-associated encephalitis. We administered a high dose of intravenous immunoglobulin since the low-grade fever and mild unconscious state had continued in spite of the treatment with methylprednisolone pulse therapy. His consciousness was restored and body temperature became normal immediately. We could confirm the efficacy of our treatment by measurement of IL-6 levels in the serum and cerebrospinal fluid during the entire clinical course. In conclusion, a high dose of intravenous immunoglobulin therapy might be one of the effective treatments for influenza-associated encephalitis.
authors: Naoki
authors: N
authors: Iwanaga
authors: Shigeki
authors: S
authors: Nakamura
authors: Akitaka
authors: A
authors: Tanaka
authors: Yuichi
authors: Y
authors: Fukuda
authors: Yoshifumi
authors: Y
authors: Imamura
authors: Taiga
authors: T
authors: Miyazaki
authors: Koichi
authors: K
authors: Izumikawa
authors: Hiroshi
authors: H
authors: Kakeya
authors: Yoshihiro
authors: Y
authors: Yamamoto
authors: Katsunori
authors: K
authors: Yanagihara
authors: Hiroshi
authors: H
authors: Soda
authors: Takayoshi
authors: T
authors: Tashiro
authors: Shigeru
authors: S
authors: Kohno
mesh_terms: D000368:Aged; D018792:Encephalitis, Viral / Q000188:drug therapy*; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000008:administration & dosage*; D007251:Influenza, Human / Q000188:drug therapy*; D008297:Male
chemical_list: D016756:Immunoglobulins, Intravenous