Coronavirus disease 2019 (COVID-19) infection primarily affects the respiratory system
leading to majority of intensive care unit admissions; nevertheless, neurologic manifestations
and complications occur and are now being reported. We present a case of a 19-year-old male
who tested positive for COVID-19 and manifested with headache, drowsiness and eventually
went into coma. Cerebrospinal fluid analyses during the early course of illness showed
predominance of lymphocytes but were negative for COVID-19 and other viral or bacterial
organisms. Cranial MRI showed bright signals in the splenium of the corpus callosum. The
patient was treated with a combination of antivirals, convalescent plasma therapy and high dose
steroid therapy. Progressive improvement in clinical status was observed after the combination
therapy including high-dose steroid, suggesting a possible inflammatory mechanism of
COVID-19-related encephalitis. The diagnosis of COVID-19 encephalitis can be challenging but
it must be considered in any COVID-19 positive patient presenting with symptoms of
encephalitis, such as fever, seizures or altered sensorium. Anticipation of long-term care should
also be taken into consideration since the long-term sequelae of CNS COVID-19 are largely
unknown.