Fever of unknown origin: An unusual presentation of anti-N-methyl-D-aspartate receptor encephalitis

Title
Fever of unknown origin: An unusual presentation of anti-N-methyl-D-aspartate receptor encephalitis
Author(s)
허지안
Keywords
aminotransferase; aspartate aminotransferase; C reactive protein; cefazolin; creatine kinase; creatinine; dexamethasone; immunoglobulin; lactate dehydrogenase; levofloxacin; methylprednisolone; n methyl dextro aspartic acid receptor; prednisolone; procalcitonin; sultamicillin; abnormal behavior; adult; aminotransferase blood level; anti n methyl d aspartate receptor encephalitis; Article; bipolar disorder; blood culture; case report; catatonia; cerebrospinal fluid analysis; cerebrospinal fluid pressure; clinical feature; computer assisted tomography; corticosteroid therapy; creatine kinase blood level; creatinine blood level; drug substitution; electroencephalogram; Enterococcus faecalis; erythrocyte sedimentation rate; female; human; hyperactivity; insomnia; laceration; lactate dehydrogenase blood level; leukocyte; leukocyte count; lymphocyte; mental disease; Mini Mental State Examination; ovary teratoma; pyrexia idiopathica; skin infection; soft tissue infection; tetanus prophylaxis; thrombocyte count; urea nitrogen blood level; visual hallucination
Issue Date
201506
Citation
Infection and Chemotherapy, v.47, no.2, pp.129 - 132
Abstract
Encephalitis associated with antibodies to the N-methyl-D-aspartate receptor (NMDAR) has variable clinical manifestations. Patients are often diagnosed with infectious processes because of prodromal symptoms and autonomic manifestations. Approximately 70% of patients have prodromal symptoms consisting of headache, fever, nausea, vomiting, and diarrhea, along with frequent autonomic manifestations, including tachycardia, and fluctuating blood pressure. A 36-year-old woman presented with uncontrolled fever and skin and soft tissue infections. She had shown psychiatric symptoms and abnormal behavior, and had been diagnosed with bipolar disorder. Antibodies to NMDAR were positive in cerebrospinal fluid (CSF) and serum samples, and pelvic computed tomography detected a large ovarian teratoma. The patient improved dramatically after removal of the teratoma and administration of corticosteroid therapy. When confronted with a young woman with uncontrolled fever and acute psychiatric symptoms, physicians should suspect anti-NMDAR encephalitis. ? 2015 by The Korean Society of Infectious Diseases.
URI
http://hdl.handle.net/YU.REPOSITORY/31935http://dx.doi.org/10.3947/ic.2015.47.2.129
ISSN
2093-2340
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의과대학 > 내과학교실 > Articles
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