Published online Sep 16, 2017. doi: 10.12998/wjcc.v5.i9.368
Peer-review started: January 6, 2017
First decision: March 7, 2017
Revised: April 20, 2017
Accepted: June 30, 2017
Article in press: July 3, 2017
Published online: September 16, 2017
We report an atypical case of anti-N-methyl-D-aspartate receptor encephalitis (ANMDARE). A 27-year-old man diagnosed with ANMDARE received immunotherapy and had a good recovery. However, within one month, he developed severe status epilepticus and decreased level of conscience with new hyperpyrexia and dyspnea, and was admitted to the emergency intensive care unit. Acinetobacter baumanii were found in the sputum culture; and anti-NMDAR antibodies were positive (titer: 1/80) in the cerebrospinal fluid. Repeated immunotherapy was administered with antibacterial agents, and the patient recovered except for mild psychiatric sequelae. This is the first report of ANMDARE that aggravates after acinetobacter baumannii pneumonia. Awareness and knowledge of this disorder should be extended, especially in the emergency medicine community.
Core tip: In this paper we presented a very rare case of an anti-N-methyl-D-aspartate receptor encephalitis in which the patient aggravated after acinetobacter baumannii pneumonia and well responded to immunotherapy. The mechanism underlying the association needs attention.