ArticleCureus2025
Fatal Case of COVID-19-Associated Acute Hemorrhagic Leukoencephalitis Without Respiratory Involvement: A Diagnostic and Therapeutic Challenge.
Article in Cureus, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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5 authors.
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Abstract
We report a rare and fatal case of acute hemorrhagic leukoencephalitis (AHLE) as the sole manifestation of COVID-19 in a 76-year-old woman who presented without respiratory symptoms. The patient was admitted with an acute altered mental status following a recent fall and a positive SARS-CoV-2 test. Initial imaging showed a small subdural hematoma; however, further evaluation revealed widespread white matter changes and petechial hemorrhages on MRI, consistent with AHLE. Despite aggressive treatment, including intravenous immunoglobulin (IVIG) and high-dose corticosteroids, the patient showed minimal neurological recovery. Cerebrospinal fluid (CSF) studies revealed elevated protein with no infectious or autoimmune markers, and the brain biopsy was non-contributory. She was ultimately transitioned to hospice care. This case underscores the importance of considering AHLE in COVID-19 patients presenting with isolated neurological deterioration, even in the absence of pulmonary involvement. Prompt recognition and escalation of care are crucial, although the prognosis remains poor.
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