Acute Necrotizing Encephalopathy in a Child during the 2009 Influenza A(H1N1) Pandemia: MR Imaging in Diagnosis and Follow-Up

Abstract

SUMMARY:The recently emerged novel influenza A(H1N1) virus continues to spread globally. The clinical disease generally appears mild, but unfavorable outcomes have been reported. We describe a case of a 3-year-old Italian girl infected with influenza A(H1N1) virus presenting with neurologic deterioration. CT findings were negative, but MR imaging findings were consistent with ANE. To our knowledge, this is the first case reported in Europe and the second in worldwide pediatric radiology literature.ABBREVIATIONS: ANE ϭ acute necrotizing encephalopathy; ANEC ϭ acute necrotizing encephalopathy of childhood; DTI ϭ diffusion tensor imaging; DWI ϭ diffusion-weighted imaging; HSV ϭ herpes simplex virus

The Value of Standardized Case Definitions in Encephalitis Clinical Research

“…67 Initial reports emerged from Japan and the United States [68][69][70][71][72][73][74][75] and recently, a number of case reports as well as surveillance reports by CDC have been issued on neurologic complications of Influenza A (in particular pandemic H1N1) disease. [76][77][78][79][80][81][82][83][84][85][86][87][88] Example 3: Encephalitis as an adverse event following immunization (AEFI)…”

Meningoencefalitis por influenza A pH1N1. Presentación de un caso clínico

“…Se detectó virus en ANF, pero no en LCR. 6 Durante la pandemia de 2009, las anomalías en las neuroimágenes de ENA, fueron observadas por primera vez en un niño de Texas. 7 Posteriormente, dos casos más por Haktanir en Turquía.…”

Are Neuroimaging Findings in Novel Influenza A(H1N1) Infection Really Novel?

“…4 Subsequently, 2 more cases of encephalitis associated with H1N1 infection have been reported by Haktanir from Turkey 5 and Ormitti et al from Italy. 6 Neuroimaging findings in influenzaassociated encephalopathy might be normal, but in severe cases, abnormalities can include diffuse cerebral edema and bilateral thalamic lesions. 2 Lack of evidence of H1N1 viral infection in the CSF suggests that neurologic manifestations might be an indirect effect of respiratory tract infection, similar to the ones observed in influenza A and B viral infections.…”