Case Report
Copyright ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Sep 16, 2017; 5(9): 368-372
Published online Sep 16, 2017. doi: 10.12998/wjcc.v5.i9.368
Anti-N-methyl-D-aspartate receptor encephalitis that aggravates after acinetobacter baumannii pneumonia: A case report
Cheng C Wang, Da J Li, Yi Q Xia, Kai Liu
Cheng C Wang, Da J Li, Kai Liu, Center of Infectious Diseases, West China Hospital of Sichuan University, Chengdu 610041, Sichuan Province, China
Yi Q Xia, Emergency Department, West China Hospital of Sichuan University, Chengdu 610041, Sichuan Province, China
Author contributions: Liu K designed the research, revised the paper and provided fundamental support; Wang CC searched the literature and wrote the paper; Li DJ and Xia YQ helped to search the literature and write the paper.
Institutional review board statement: This case report was exempt from the Institutional Review Board standards at West China Hospital of Sichuan University, Chengdu 610041, Sichuan Province, China.
Informed consent statement: The patient involved in this study gave his written informed consent authorizing use and disclosure of his protected health information.
Conflict-of-interest statement: The authors have declared no competing interests exist.
Data sharing statement: No additional data are available.
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/
Correspondence to: Dr Kai Liu, Associate Professor, Center of Infectious Diseases, West China Hospital of Sichuan University, No.37 Guo Xue Xiang, Wuhou District, Chengdu 610041, Sichuan Province, China. liubusiness@163.com
Telephone: +86-28-85423597 Fax: +86-28-85423597
Received: January 3, 2017
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
Abstract

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.

Keywords: Anti-N-methyl-D-aspartate receptor encephalitis, Acinetobacter baumannii pneumonia, Emergency

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.