Fever of Unknown Origin: An Unusual Presentation of Anti-N-Methyl-D-Aspartate Receptor Encephalitis.
- Author:
Jian HUR
1
Author Information
- Publication Type:Case Report
- Keywords: Fever of unknown origin; Anti-N-methyl-D-aspartate receptor encephalitis; Dermoid cyst
- MeSH: Adult; Anti-N-Methyl-D-Aspartate Receptor Encephalitis*; Antibodies; Bipolar Disorder; Blood Pressure; Cerebrospinal Fluid; Dermoid Cyst; Diarrhea; Encephalitis; Female; Fever; Fever of Unknown Origin*; Headache; Humans; N-Methylaspartate; Nausea; Prodromal Symptoms; Skin; Soft Tissue Infections; Tachycardia; Teratoma; Vomiting
- From:Infection and Chemotherapy 2015;47(2):129-132
- CountryRepublic of Korea
- Language:English
- 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.
