Your browser doesn't support javascript.
Show: 20 | 50 | 100
Results 1 - 3 de 3
Chest ; 159(2): e107-e113, 2021 02.
Article in English | MEDLINE | ID: covidwho-1053266


CASE PRESENTATION: A 53-year-old man presented to the ED at a time of low severe acute respiratory syndrome coronavirus 2, also known as coronavirus disease 2019 (COVID-19), prevalence and reported 2 weeks of progressive shortness of breath, dry cough, headache, myalgias, diarrhea, and recurrent low-grade fevers to 39°C for 1 week with several days of recorded peripheral capillary oxygen saturation of 80% to 90% (room air) on home pulse oximeter. Five days earlier, he had visited an urgent care center where a routine respiratory viral panel was reportedly negative. A COVID-19 reverse transcriptase polymerase chain reaction test result was pending at the time of ED visit. He reported a past medical history of gastroesophageal reflux disease that was treated with famotidine. Travel history included an out-of-state trip 3 weeks earlier, but no recent international travel.

COVID-19/diagnostic imaging , Lung/diagnostic imaging , Bacteremia/complications , COVID-19/complications , COVID-19/physiopathology , COVID-19 Nucleic Acid Testing , Cerebellar Diseases/complications , Cerebellar Diseases/diagnostic imaging , Cough/physiopathology , Diarrhea/physiopathology , Disease Progression , Dyspnea/physiopathology , Emergency Service, Hospital , Fever/physiopathology , Headache/physiopathology , Humans , Ischemic Stroke/complications , Ischemic Stroke/diagnostic imaging , Lymphopenia/physiopathology , Magnetic Resonance Imaging , Male , Middle Aged , Myalgia/physiopathology , Oximetry , Pneumonia, Staphylococcal/complications , Radiography, Thoracic , SARS-CoV-2 , Staphylococcal Infections/complications , Tomography, X-Ray Computed
Acta Neuropathol Commun ; 8(1): 147, 2020 08 26.
Article in English | MEDLINE | ID: covidwho-730088


We document the neuropathologic findings of a 73-year old man who died from acute cerebellar hemorrhage in the context of relatively mild SARS-CoV2 infection. The patient developed sudden onset of headache, nausea, and vomiting, immediately followed by loss of consciousness on the day of admission. Emergency medical services found him severely hypoxemic at home, and the patient suffered a cardiac arrest during transport to the emergency department. The emergency team achieved return of spontaneous circulation after over 17 min of resuscitation. A chest radiograph revealed hazy bilateral opacities; and real-time-PCR for SARS-CoV-2 on the nasopharyngeal swab was positive. Computed tomography of the head showed a large right cerebellar hemorrhage, with tonsillar herniation and intraventricular hemorrhage. One day after presentation, he was transitioned to comfort care and died shortly after palliative extubation. Autopsy performed 3 h after death showed cerebellar hemorrhage and acute infarcts in the dorsal pons and medulla. Remarkably, there were microglial nodules and neuronophagia bilaterally in the inferior olives and multifocally in the cerebellar dentate nuclei. This constellation of findings has not been reported thus far in the context of SARS-CoV-2 infection.

Brain Stem Infarctions/pathology , Cerebellar Diseases/pathology , Coronavirus Infections/pathology , Intracranial Hemorrhages/pathology , Microglia/pathology , Neurons/pathology , Phagocytosis , Pneumonia, Viral/pathology , Aged , Betacoronavirus , Brain Stem Infarctions/complications , Brain Stem Infarctions/diagnostic imaging , COVID-19 , Cerebellar Diseases/complications , Cerebellar Diseases/diagnostic imaging , Cerebellar Nuclei/pathology , Coronavirus Infections/complications , Coronavirus Infections/diagnosis , Headache/etiology , Heart Arrest/etiology , Humans , Hypoxia/etiology , Intracranial Hemorrhages/complications , Intracranial Hemorrhages/diagnostic imaging , Male , Medulla Oblongata/diagnostic imaging , Medulla Oblongata/pathology , Olivary Nucleus/pathology , Pandemics , Pneumonia, Viral/complications , Pneumonia, Viral/diagnosis , Pontine Tegmentum/diagnostic imaging , Pontine Tegmentum/pathology , SARS-CoV-2 , Tomography, X-Ray Computed
Cerebellum ; 19(6): 911-914, 2020 Dec.
Article in English | MEDLINE | ID: covidwho-690463


Novel coronavirus (severe acute respiratory syndrome-coronavirus-2: SARS-CoV-2), which originated from Wuhan, China, has spread to the other countries in a short period of time. We report a 47-year-old male who was admitted to our hospital due to suffering from progressive vertigo and ataxia for 7 days prior to the admission. Neurological examination revealed cerebellar dysfunction, and brain magnetic resonance imaging (MRI) depicted edema of the cerebellar hemisphere associated with leptomeningeal enhancement. Cerebrospinal fluid (CSF) analysis showed mild lymphocytic pleocytosis, elevated protein, and lactate dehydrogenase. SARS-CoV-2 RNA was detected in the oropharyngeal/nasopharyngeal and CSF specimens. As a result, treatment with lopinavir/ritonavir was initiated, and patient symptoms and signs improved significantly during the course of hospitalization. To the best of our knowledge, this is the first case of acute cerebellitis associated with COVID-19 disease which is reported in the literature so far.

Betacoronavirus , Cerebellar Diseases/complications , Cerebellar Diseases/diagnostic imaging , Coronavirus Infections/complications , Coronavirus Infections/diagnostic imaging , Pneumonia, Viral/complications , Pneumonia, Viral/diagnostic imaging , Acute Disease , COVID-19 , Humans , Male , Middle Aged , Pandemics , SARS-CoV-2