A Case Report of a Boy With Clinically Mild Encephalopathy and a Reversible Splenial Lesion Associated With Severe Acute Respiratory Syndrome-Coronavirus 2 Infection

一例伴有临床轻度脑病和可逆性脾脏病变的重症急性呼吸综合征冠状病毒2感染男孩病例报告

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Abstract

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is associated with a high frequency of central nervous system abnormalities, particularly acute encephalopathy, in children. We report the case of a nine-year-old boy with SARS-CoV-2-associated clinically mild encephalopathy with a reversible splenial lesion. The patient was admitted to our hospital with fever, vomiting, and poor speech. The patient tested positive for SARS-CoV-2 by polymerase chain reaction of a nasal swab sample. The cerebrospinal fluid cell count was normal. The patient had a low serum sodium level upon admission. Computed tomography of the brain revealed mild cerebral edema. Diffusion-weighted magnetic resonance imaging (MRI) revealed transient abnormally high signal intensity in the splenium of the corpus callosum. Electroencephalography revealed generalized high-voltage slow waves. The patient was clinically diagnosed with mild encephalopathy and a reversible splenial lesion associated with SARS-CoV-2 infection. The patient was discharged without any neurological sequelae. In conclusion, it is useful to perform MRI evaluations in children with SARS-CoV-2 infection and impaired consciousness, poor speech, and behavior, considering the possibility that they may be in the early stages of encephalopathy.

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