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Year : 2022  |  Volume : 1  |  Issue : 3  |  Page : 64-66

Imaging clues for an early diagnosis of Nipah encephalitis, a new epidemic alert—2021

1 Department of Adult and Paediatric Neurosciences, Aster Malabar institute of Medical Sciences, Kozhikode, Kerala, India
2 Department of Radiology, Aster Malabar institute of Medical Sciences, Kozhikode, Kerala, India
3 Department of Pediatrics, Aster Malabar institute of Medical Sciences, Kozhikode, Kerala, India

Correspondence Address:
Dr. Smilu Mohanlal
Department of Adult and Paediatric Neurosciences, Aster MIMS, Kozhikode 673016, Kerala
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/pedc.pedc_8_23

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We report an interesting case of viral encephalitis where neuroimaging and a careful clinicoepidemiologic correlation led to the diagnosis, and we could alert the public health facilities to take measures to contain the spread. A 12-year-old boy presented with fever, headache, photophobia, seizures, and altered sensorium. Magnetic resonance imaging brain revealed T2 FLAIR hyperintensities in bilateral cerebral hemispheres. The differential diagnoses considered were viral/bacterial/rickettsia encephalitis/vasculitis. He also had myocarditis and acute respiratory distress syndrome (ARDS). On careful observation of this triad of encephalitis, myocarditis, ARDS, and previous experience of Nipah encephalitis in North Kerala (Kozhikode), cerebrospinal fluid for Nipah virus isolation was sent and that was positive. Though the boy succumbed to ARDS, health authorities took measures such as quarantine measures, careful disposal of the body, and lockdown measures in the locality to curb the spread. This case report highlights the importance of careful clinicoradiologic epidemiologic correlation in unexplained encephalitis.

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