Qi ZL, Sun LY, Bai J, Zhuang HZ, Duan ML. Japanese encephalitis following liver transplantation: A rare case report. World J Clin Cases 2020; 8(2): 337-342 [PMID: 32047783 DOI: 10.12998/wjcc.v8.i2.337]
Corresponding Author of This Article
Mei-Li Duan, MD, PhD, Chief Doctor, Department of Intensive Care Unit, Beijing Friendship Hospital, Capital Medical University, 95 Yong An Road, Xi Cheng District, Beijing 100050, China. 13001058598@163.com
Research Domain of This Article
Transplantation
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Zhi-Li Qi, Li-Ying Sun, Jing Bai, Hai-Zhou Zhuang, Mei-Li Duan, Department of Intensive Care Unit, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
Li-Ying Sun, Beijing Key Laboratory of Tolerance Induction and Organ Protection in Transplantation, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
Author contributions: Qi ZL was the patient’s competent physician, reviewed the literature, and contributed to manuscript drafting; Bai J and Zhuang HZ were the patient’s attending physicians and contributed to manuscript drafting; Sun LY obtained informed consent and provided important intellectual content; Duan ML was responsible for revision of the manuscript; all authors gave final approval for the version to be submitted.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflicts of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Mei-Li Duan, MD, PhD, Chief Doctor, Department of Intensive Care Unit, Beijing Friendship Hospital, Capital Medical University, 95 Yong An Road, Xi Cheng District, Beijing 100050, China. 13001058598@163.com
Received: November 10, 2019 Peer-review started: November 10, 2019 First decision: November 19, 2019 Revised: November 25, 2019 Accepted: December 6, 2019 Article in press: December 6, 2019 Published online: January 26, 2020 Processing time: 67 Days and 15.8 Hours
Abstract
BACKGROUND
Japanese encephalitis (JE) is a serious public health concern with a high mortality rate in many Asian countries. For many years, JE virus (JEV) was considered the major cause of viral encephalitis in Asia. Although most JE cases are asymptomatic, the case fatality rate approaches 30%, and approximately 30%–50% of survivors have long-term neurological sequelae. To the best of our knowledge, JEV infection has never been reported following liver transplantation.
CASE SUMMARY
We report a case of a woman who underwent liver transplantation for autoimmune liver disease but presented with fever and neurological symptoms 13 d after transplantation. Magnetic resonance imaging revealed JEV infection, and positive immunoglobulin M antibody to JEV in blood and cerebrospinal fluid confirmed JE. The patient was treated with antiviral agents, immune regulation, and organ function support. No neurological sequelae were present after 1 year of follow-up.
CONCLUSION
Imaging and lumbar puncture examination should be performed as soon as possible in patients with fever and central nervous system symptoms after liver transplantation, and the possibility of atypical infection should be considered, which is helpful for early diagnosis and improved prognosis.
Core tip: Japanese encephalitis is a serious public health concern with a high mortality rate in many Asian countries. We describe a rare case of a woman who underwent liver transplantation and was subsequently diagnosed with Japanese encephalitis. This case highlights the need for performing imaging and lumbar puncture examination as soon as possible in patients with fever and central nervous system symptoms after liver transplantation.
