Transient splenial lesion as late complication of COVID-19 infection

Lesão esplênica transitória como complicação tardia da infecção por COVID-19

A 33-year-old woman presented with breathing discomfort, cough, and fever. The real-time reverse-transcriptase polymerase-chain-reaction (rRT-PCR) analysis was positive for coronavirus disease 2019 (COVID-19). The computed tomography (CT) scan showed ground glass opacities in lung parenchyma (►Figure 1A-C). The patient was treated with favipiravir. One month after discharge, the magnetic resonance imaging (MRI) scan showed a lesion in the corpus callosum (►Figure 2A–B). The imaging results were compatible with a transient splenial lesion. The patient was completely recovered after 1 month, without any specific treatment. Control MRI showed complete resolution of the lesion (►Figure 2C-D). We thought that the splenial lesion was caused by the coronavirus infection; COVID-19 infection presenting with transient splenial lesion in an adult patient has been reported in only a few cases.¹, ², ³

Figure 1
(A–C) Axial thorax CT during the presentation scans show ground glass opacities (circles) in both lung parenchyma.

Figure 2
(A and B) One month after successful therapy, diffusion weight imaging (DWI) shows significant diffusion restriction with reduced apparent diffusion coefficient (ADC) in the lesion. (C and D) One month after first MRI scan, DWI and ADC map reveal completely resolution of the lesion.

References

• ¹
  Hayashi M, Sahashi Y, Baba Y, Okura H, Shimohata T. COVID-19-associated mild encephalitis/encephalopathy with a reversible splenial lesion. J Neurol Sci 2020;415:116941
• ²
  El Aoud S, Sorial D, Selmaoui A, et al. A first case of Mild Encephalitis with Reversible Splenial Lesion(MERS) as a presenting feature of SARS-CoV-2. Rev Neurol (Paris) 2021;177(1-2):139–141
• ³
  Chauffier J, Poey N, Husain M, et al. First Case of Mild Encephalopathy with Reversible Splenial Lesion in SARS-CoV-2 Infection. Infect Dis Now 2021;51(01):99–101

Publication Dates

• Publication in this collection
  23 Jan 2023
• Date of issue
  2022

History

• Received
  11 Nov 2021
• Accepted
  19 Feb 2022