A case of new onset refractory status epilepticus in a U.S. traveler with Japanese encephalitis.

New onset refractory status epilepticus (NORSE) is a rare but critical condition characterized by refractory status epilepticus (RSE) in an individual without prior history of epilepsy or known structural, toxic, or metabolic cause. Postinfectious immune activation is an important cause of NORSE. Early testing for autoimmune antibodies is strongly recommended (Wickstrom et al., 2022). We report a case of NORSE triggered by Japanese encephalitis (JE) in an unvaccinated US adult traveler. Her CSF later revealed positive anti-N-methyl-d-aspartate (NMDA)-receptor antibody. The patient responded well to first line immunotherapy with favorable functional outcome. This case highlights the diagnostic and treatment challenges in this rare presentation.

Prolonged Sars-CoV-2 Viral Culture Detected in a Mild COVID-19 Infection.

We describe a case of prolonged shedding of live Severe Acute Respiratory Syndrome Coronavirus, 2 in the setting of a mild novel Coronavirus Disease 2019 (COVID-19) infection in a healthy young adult male. The patient did not require hospitalization or any supplemental oxygen. The viral cultures remained positive 15 days from symptom onset. The extended duration of positive viral culture with his concurrent mild symptomatology is at odds with current CDC and DOD isolation policies for positive COVID-19 patients. This case is important as health agencies around the world grapple with how to advise patients and create protocols for isolation precautions after positive COVID-19 results.