DOI: 10.12890/2025_005235
Delayed neurological sequelae of carbon monoxide intoxication initially treated as infectious meningo encephalitis
Authors
noellorenzo@gmail.com
Keywords
Carbon monoxide intoxication, delirum, meningo-encephalitisAbstract
We report the case of a 75-year-old woman admitted to the emergency department for confusion, gait disturbances and mutism associated with an inflammatory syndrome occurring 3 weeks after acute carbon monoxide intoxication. The main hypothesis upon arrival was infectious meningoencephalitis, and the patient was put on acyclovir and antibiotics in meningeal doses. After a short stay in intensive care, the patient’s condition did not improve, and the revaluation of her case history and imaging studies led to the diagnosis of post-interval syndrome secondary to carbon monoxide intoxication after a 3-week asymptomatic period. Post-interval syndrome is a complication poorly known to clinicians, manifesting as neuropsychiatric disorders after carbon monoxide intoxication despite an initial period of improvement. Repeated magnetic resonance imaging, in conjunction with compatible clinical findings, allow the diagnosis to be made. No neurological improved was noted after 6 months follow-up.
References
- Lee S, Howard MA 3rd, Han JH. Delirium and Delirium Prevention in the Emergency Department. Clin Geriatr Med 2023;39:535-551.
- Reumuth G, Alharbi Z, Houschyar KS, Kim BS, Siemers F, Fuchs PC, et al. Carbon monoxide intoxication: What we know. Burns 2019;45:526-530.
- Weaver LK. Carbon Monoxide Poisoning. N Engl J Med 2009;360:1217-1225.
- Eichhorn L, Thudium M, Jüttner B. The Diagnosis and Treatment of Carbon Monoxide Poisoning. Dtsch Arztebl Int 2018;115:863-870.
- Choi IS. Delayed neurologic sequelae in carbon monoxide intoxication. Arch Neurol 1983;40:433-435.
- Geraldo AF, Silva C, Neutel D, Neto LL, Albuquerque L. Delayed leukoencephalopathy after acute carbon monoxide intoxication. J Radiol Case Rep 2014;8:1-8.
- Hu H, Pan X, Wan Y, Zhang Q, Liang W. Factors affecting the prognosis of patients with delayed encephalopathy after acute carbon monoxide poisoning. Am J Emerg Med 2011;29:261-264.
- Shprecher D, Mehta L. The syndrome of delayed post-hypoxic leukoencephalopathy. NeuroRehabilitation 2010;26:65-72.