Background: Influenza A H1N1 pdm09-associated neurological complications are rare, particularly in adults. This case report highlights one of the uncommon presentations associated with H1N1 pdm09 infection.
Case Presentation: We present the case of a 38-year-old male who was admitted to the hospital primarily with respiratory manifestations and developed acute cerebellar ataxia during hospital stay, causing a diagnostic dilemma, as his cerebrospinal fluid analysis and magnetic resonance imaging brain were unremarkable. Throat swab real-time reverse transcriptase polymerase chain
reaction (rRT-PCR) turned out positive for influenza A (H1N1) pdm09 virus strain and a nontypeable influenza A strain. He showed the resolution of cerebellar signs and a remarkable recovery on oseltamivir therapy. Based on the acute onset, positive RT-PCR and recovery on antiviral, a diagnosis of H1N1-associated cerebellitis was made.
Conclusion: This report highlights an extremely rare complication of influenza infection with only five reported cases in adults and case series in children. Vigilance and a high index of suspicion for patients presenting with rapid onset neurological deterioration during pandemics and seasonal epidemics can prevent devastating sequelae.
Key words: Cerebellitis, influenza, cerebellar ataxia, influenza-associated encephalopathy, case report
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