Neuroimaging Manifestations and Clinical Correlates of Japanese Encephalitis: Insights from an MRI Case Series
Correspondence Address :
Dr. Ajay Lucas Rubben,
Junior Resident, Department of Radiology, Saveetha Institute of Medical and Technical Science, Chennai-602105, Tamil Nadu, India.
E-mail: mslucas007@gmail.com
Japanese Encephalitis (JE) poses a significant public health threat across Asia and the Western Pacific, leading to considerable mortality and morbidity if not promptly diagnosed and treated. This flaviviral infection, transmitted by Culex mosquitoes, primarily affects children but can impact individuals of all ages. Prompt diagnosis relies on detecting Japanese Encephalitis Virus (JEV) IgM antibodies in serum or Cerebrospinal Fluid (CSF), alongside characteristic Magnetic Resonance Imaging (MRI) findings. In this MRI case series, three confirmed cases of JE are presented, showcasing the typical neuroimaging manifestations observed in affected individuals. All cases exhibited bilateral thalamic hyperintensities on T2-weighted and Fluid Attenuated Inversion Recovery (FLAIR) images, a hallmark feature of JE. Additionally, one patient demonstrated involvement of the substantia nigra and bilateral frontal cortex. The clinical implications of present study findings underscore the importance of considering JE as a differential diagnosis in patients presenting with symptoms of encephalitis, especially when MRI reveals bi-thalamic signal alterations. Early recognition and initiation of appropriate treatment, including antiviral agents, are crucial for improving outcomes and reducing mortality. This study contributes to the existing literature by reinforcing the importance of neuroimaging in diagnosing JE and highlighting the distinct MRI patterns associated with the disease. Recognising these characteristic imaging features can aid clinicians in promptly identifying and managing JE cases, thereby mitigating the associated morbidity and mortality.
Bilateral thalamic hyperintensities, Diagnosis, Infectious disease, Magnetic resonance imaging
DOI: 10.7860/JCDR/2024/69964.19347
Date of Submission: Feb 06, 2024
Date of Peer Review: Feb 22, 2024
Date of Acceptance: Feb 29, 2024
Date of Publishing: May 01, 2024
AUTHOR DECLARATION:
• Financial or Other Competing Interests: None
• Was informed consent obtained from the subjects involved in the study? Yes
• For any images presented appropriate consent has been obtained from the subjects. Yes
PLAGIARISM CHECKING METHODS:
• Plagiarism X-checker: Feb 07, 2024
• Manual Googling: Feb 25, 2024
• iThenticate Software: Feb 28, 2024 (10%)
ETYMOLOGY: Author Origin
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