A case of Japanese encephalitis misdiagnosed as tuberculous meningoencephalitis

Abstract

Backgroud Japanese encephalitis is a kind of central nervous system infectious disease caused by Japanese encephalitis virus transmitted through mosquito[1].Most patients with JE are acute onset and critically ill, with high fever, disturbance of consciousness, epilepsy, abnormal mental behavior, cognitive impairment, and positive meningeal irritation. Case presentation A 15-year-old boy was admitted to the hospital with acute febrile illness,headache,jet vomiting,disorder of consciousness,diagnosed as central nervous system (CNS) infection. According to the characteristics of blood and cerebrospinal fluid (CSF), the patient was initially diagnosed with meningoencephalitis and took antituberculosis treatment.However,subsequent magnetic resonance images(MRI) did not match the performance of typical tuberculous meningoencephalitis.Further laboratory testing for infections was conducted. JE was confirmed by the Disease Control Center of Lanzhou City through the detection of Japanese encephalitis IgM antibodies in both blood and CSF of the patients.After diagnosis of JE, the patient was provided the treatment of Human immunoglobulin and methylprednisolone therapy.After 3 weeks, the patient was transferred to the department of rehabilitation medicine to continue treatment. After 3 months and 6 months of follow-up, the patient recovered and the FIM score were 126, which were completely independent. Conclusion Given the similar clinical manifestations of Japanese encephalitis and other types of encephalitis, it is essential to enhance the awareness of Japanese encephalitis.