Acute Fulminant Cerebral Edema Presenting as Refractory Status Epilepticus in a SARS-CoV-2 PCR-Positive Child Without Pulmonary Involvement: Correspondence

Excerpt

To the Editor: Regarding the Article by Botre et al. Published in IJP [1], the main limitation is the absence of autopsy to uncover the cause of acute fulminant cerebral edema (AFCE). Because AFCE is per definition due to encephalitis, the patient should have been examined for all possible bacterial, viral (including HIV and SARS-CoV-2), fungal, parasitic, and plasmodial causes of infectious encephalitis. Because the patient was also SARS-CoV-2 positive, it is conceivable that AFCE was due to SARS-CoV-2-related autoimmune encephalitis (AIE), which has been repeatedly reported [2]. AIE can go along with/without cerebrospinal fluid (CSF) antibodies against more than 20 cerebral targets [3]. If CSF is still available, these autoantibodies (e.g., MDPA, AMPA, GABA-B, GLI1) should be determined. Regarding the cause of AFCE, one should know whether multisystem inflammatory syndrome in children was considered and adequately ruled out. …