Fatal Meningoencephalitis in a COVID-19 Patient in Bangladesh — A Rare Case Report

Abstract

Introduction: The following case report delves into a unique and intricate manifestation of COVID-19 involving meningoencephalitis and a traumatic subdural hematoma (SDH). This particular case centers on a 54-year-old woman who had a complex medical history, including pre-existing conditions such as diabetes, hypertension, chronic kidney disease, and ischemic heart disease. This case is particularly noteworthy due to the simultaneous occurrence of meningoencephalitis and a traumatic SDH in a COVID-19 patient with an extensive list of comorbidities. Case Presentation: The patient's presentation was undeniably complex, necessitating careful examination and intervention. Her underlying health conditions, including diabetes, hypertension, chronic kidney disease, and ischemic heart disease, established a challenging backdrop for managing her COVID-19-related complications. The initial mild fever progressed to severe respiratory distress and neurological symptoms, leading to her admission to the Intensive Care Unit. At this point, her condition was characterized by a Glasgow Coma Scale (GCS) score of 10/15 and an oxygen saturation (SaO2) of 88% on room air. Diagnostic tests left no room for doubt, confirming both SARS-CoV-2 infection and elevated inflammatory markers. Conclusion: This extraordinary case underscores the intricate interplay of COVID-19 with various comorbidities, resulting in a complex clinical presentation. Of particular interest is the concomitant occurrence of meningoencephalitis and a traumatic subdural hematoma in a patient grappling with multiple pre-existing health conditions. The diagnostic challenges presented by the absence of advanced tests like cerebrospinal fluid RT-PCR for SARS-CoV-2 cannot be overstated.