• Linda C Wendell, N Stevenson Potter, Julie L Roth, Stephen P Salloway, and Bradford B Thompson.
• Departmentsof Neurology,Rhode Island Hospital/Warren Alpert School of Medicine at Brown University, 593 Eddy Street, APC 712, Providence, RI 02903, USA. linda_wendell@brown.edu
• Neurocrit Care. 2013 Aug 1; 19 (1): 111-5.

BackgroundEastern Equine Encephalitis (EEE) virus is an arbovirus that mostly causes asymptomatic infection in humans; however, some people can develop a neuroinvasive infection associated with a high mortality.MethodsWe present a case of a patient with severe neuroinvasive EEE.ResultsA 21-year-old man initially presented with headache, fever, and vomiting and was found to have a neutrophilic pleocytosis in his cerebrospinal fluid. He eventually was diagnosed with EEE, treated with high-dose methylprednisolone and intravenous immunoglobulin. His course in the NeuroIntensive Care Unit was complicated by cerebral edema and intracranial hypertension, requiring osmotherapy, pentobarbital and placement of an external ventricular device, and subclinical seizures, necessitating multiple anti-epileptic drugsConclusionsA multifaceted approach including aggressive management of cerebral edema and ICP as well as treatment with immunomodulating agents and cessation of seizures may prevent brain herniation, secondary neurologic injury and death in patients with EEE. Effective management and treatment in our patient contributed to a dramatic recovery and ultimate good outcome.

25 keywords...

hide…