A case of limbic encephalitis with CSF detection of sars-cov2 virus: Immune-mediated mechanism or direct viral damage?

Abstract

Background and aimsOlfactory and gustatory dysfunctions were presented in a high percentage of COVID-19 cases. Most of them are represented by quantitative disorders. Qualitative alterations were established in a small proportion. During the Covid-19 pandemic, there is a need to make a differential diagnosis (DD) of olfactory and gustatory disorders. MethodsClinical case of a 64-year-old man presented with dairy food cacosmia and dysgeusia for the last two weeks, and night sweats. From medical history we found that our patient recovered from COVID-19 infection, one month ago. ResultsBased on some studies, patients with COVID-19 infection, presented moderate to severe olfactory or gustatory dysfunctions for long-term, in convalescent period. It's important to make a DD of smell and taste impairements and choose the necessary treatment. Esophageal candidiasis was diagnosed in our patient. After 21 days of antifungal treatment cacosmia and dysgeusia disappeared. HIV test was negative. Some studies presented that COVID-19 infection is linked with a continuous reduction in lymphocytes along the disease. We hypothesized that immunodeficiency in COVID-19 infection and antibiotic therapy could be the trigger for esophageal candidiasis in our case. ConclusionsOur case report highlighted the importance of smell and taste disorders DD, in COVID-19 pandemic. Dairy food cacosmia and dysgeusia can be a sign of esophageal candidiasis. That's why, convalescent COVID-19 infection patients should be monitored for a long-term period.

Clinical Implications of COVID-19 Presence in CSF: Systematic Review of Case Reports

“…All 46 records’ full-texts were obtained and screened for eligibility. Twenty-three articles were excluded for the reasons shown in Figure 1 (citation of those records and full reasoning for exclusion is provided in Table S2 in Supplementary Materials ), and the remaining 23 articles were included in our data synthesis [ 11 , 12 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 ].…”

“…The following supporting information can be downloaded at: , Table S1: Prisma checklist, search strategy, Table S2: Excluded articles at full-text screening, Table S3: Quality assessment. References [ 11 , 12 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 45 , 48 , 55 , 71 , 72 , 73 , 74 , 75 , 76 , 77 , 78 , 79 , 80 , 81 , 82 , 83 , 84 , 85 , 86 , 87 , 88 , 89 , 90 ] are cited in Supplementary Materials.…”