Spontaneous intracranial hemorrhage in a patient with Middle East respiratory syndrome corona virus

Fahad M. Al-Hameed

Abstract


The Middle East respiratory syndrome corona virus (MERS-CoV) is a novel positive sense singlestranded ribonucleic acid virus of the genus Beta corona virus. This virus was first isolated from a patient who died from severe respiratory illness in June 2012 in Jeddah, Kingdom of Saudi Arabia. We describe an unusual case of a 42 year old healthcare worker who was admitted to our Intensive Care Unit (ICU)King Abdul-Aziz Medical City, with MERS-CoV and severe acute respiratory distress Syndrome and developed a sudden-onset diabetes insipidus and spontaneous massive intracranial hemorrhage with intra-ventricular extension and tonsillar herniation. Computed angiogram of the brain did not reveal any aneurysm or structural defects. She never had uncontrolled hypertension, or coagulopathy, nor she received antiplatelets. We are reporting a rare case of structural neurological damage associated with MERS-CoV infection.

Saudi Med J 2017; Vol. 38 (2): 196-200

doi: 10.15537/smj.2017.2.16255


How to cite this article:

Al-Hameed FM. Spontaneous intracranial hemorrhage in a patient with Middle East respiratory syndrome corona virus. Saudi Med J. 2017 Feb;38(2):196-200. doi: 10.15537/smj.2017.2.16255.



Keywords


Middle East Respiratory Syndrome Corona Virus; MERS-CoV; Respiratory failure; ARDS; Diabetes Insipidus; Spontaneous Intracranial Hemorrhage; CNS complication

Full Text:

PDF HTML

References


Van Boheemen S, de Graaf M, Lauber C, Bestebroer TM, Raj VS, Zaki AM, et al. Genomic characterization of a newly discovered coronavirus associated with acute respiratory distress syndrome in humans. MBio 2012; 3: 473-412.

Zaki AM, van Boheemen S, Bestebroer TM, Osterhaus AD, Fouchier RA. Isolation of a novel coronavirus from a man with pneumonia in Saudi Arabia. N Engl J Med 2012 8; 367: 1814-1820.

World Health Orgnization: Middle East respiratory syndrome coronavirus (MERS-CoV). WHO. Geneva (CH); 2015 Avaliable from: http://www.who.int/emergencies/mers-cov/en/

Al-Tawfiq JA, Assiri A, Memish ZA. Middle East respiratory syndrome novel corona MERS-CoV infection. Epidemiology and outcome update. Saudi Med J 2013; 34: 991-994.

Arabi YM, Arifi AA, Balkhy HH, Najm H, Aldawood AS, Ghabashi A, et al. Clinical course and outcomes of critically ill patients with Middle East respiratory syndrome corona virus infection. Ann Intern Med 2014; 160: 389-397.

Raj VS, Mou H, Smits SL, Dekkers DH, Müller MA, Dijkman R, et al. Dipeptidyl peptidase 4 is a functional receptor for the emerging human corona virus-EMC. Nature 2013; 495: 251-254.

Lamers D, Famulla S, Wronkowitz N, Hartwig S, Lehr S, Ouwens DM, et al. Dipeptidyl peptidase 4 is a novel adipokine ptenially linking obesity to the metabolic syndrome. Diabetes 2011; 60: 1917-1925.

Barnett A. DPP-4 inhibitors and their potential role in the management of type 2 diabetes. Int J Clin Pract 2006; 60: 1454-1470.

Gu J, Gong E, Zhang B, Zheng J, Gao Z, Zhong Y, et al. Multiple organ infection and the pathogenesis of SARS. J Exp Med 2005; 202: 415-24.

Xu J, Zhong S, Liue J, Li L, Li Y, Wu X, et al. Detection of severe acute respiratory syndrome corona virus in the brain: potential role of the chemoking mig in pathogenesis. Clin Infect Dis 2005; 41: 1089-1096.

Falzarano D, de Wit E, Rasmussen AL, Feldmann F, Okumura A, Scott DP, et al. Treatment with interferon-alph2b and ribavirin improves outcome in MERS-CoV-infected rhesus macaques. Nat Med 2013; 19: 1313-1317.

Arabi YM, Harthi A, Hussein J, Bouchama A, Johani S, Hajeer AH, et al. severe neurologic syndrome associated with Middle East respiratory syndrome corona virus (MERS-CoV). Infection 2015; 43: 495-501.


Refbacks

  • There are currently no refbacks.




Saudi Medical Journal is copyright under the Berne Convention and the International Copyright Convention.  Saudi Medical Journal is an Open Access journal and articles published are distributed under the terms of the Creative Commons Attribution-NonCommercial License (CC BY-NC). Readers may copy, distribute, and display the work for non-commercial purposes with the proper citation of the original work. Electronic ISSN 1658-3175. Print ISSN 0379-5284.