14 December 2020
: Case report
A 23-Year-Old Man with SARS-CoV-2 Infection Who Presented with Auditory Hallucinations and Imaging Findings of Cytotoxic Lesions of the Corpus Callosum (CLOCC)
Unusual clinical course
Walid Elkhaled1ABCDEFG*, Fatma Ben Abid23ABCDEFG, Naveed Akhtar4BCDEG, Mohamed R. Abukamar2BCDG, Wanis H. Ibrahim35BCDEGDOI: 10.12659/AJCR.928798
Am J Case Rep 2020; 21:e928798
Table 2. A Summary of individual cases reporting CLOCC in context of SARS-CoV-2 infection.
Author(s) | Age/Sex | Clinical presentation | Confirmed SARS-CoV-2 serology/RT-PCR | MRI findings | Outcome |
---|---|---|---|---|---|
Kakadia Do et al. []15 | 69/M | Disorientation, inattention, bradyphrenia, fever | Elevated SARS-CoV-2 IgM and IgG antibodies | Hyperintensity in SCC | Complete resolution of neurological symptoms and corpus callosum lesion after 2 weeks |
Agarwa et al. []16 | 73/M | Altered consciousness, fever, and respiratory distress | PCR positive for SARS-CoV-2 | Isolated lesion in SCC | Improved and stepped down from ICU after 4 weeks. No documentation about resolution of corpus callosum lesion or neurological status follow-up |
Hayashi et al. []17 | 75/M | Altered sensorium, tremors, ataxia, and urinary incontinence | PCR positive for SARS-CoV-2 | Abnormal hyperintensity in SCC | Neurological symptoms resolved after 3 days. Patient died after 12 days secondary to respiratory failure |
Moreau et al. []18 | 26/M | Acute confusion, agitation, inappropriate speech, fever, dry cough | Positive SARS-CoV-2 IgG | Hyperintense round lesion in SCC | Neurological status improved within 48 h and his cardiac dysfunction resolved within 1 week. Follow-up MRI showed resolution of the corpus callosum lesion |
Forestier et al. []7 | 55/M | Headache, high-grade fever, dizziness and impaired consciousness | PCR positive for SARS-Cov-2 | Increased diffusion-weighted signal in SCC | Improved and extubated 17 days later, follow up MRI showed complete regression of the corpus callosum lesion |
CLOCC – cytotoxic lesions of corpus callosum; SCC – splenium of corpus callosum; RT-PCR – real-time reverse transcription polymerase chain reaction test; SARS-CoV-2 – severe acute respiratory syndrome coronavirus 2. |