case_images: PMC11046109_01
case_images: Transthoracic echocardiogram showing a large pericardial effusion (orange arrow) with impending cardiac tamponade.
case_images: qmj-2024-qitc-02-016-g001.jpg
case_images: PMC11046109_01_qmj-2024-qitc-02-016-g001.jpg
case_images: fig1
case_images: Case 1: A 22-year-old woman with influenza B presented with acute dyspnea and was found to have cardiac tamponade (Figure 1).
case_images: MRI brain with contrast showing acute hemorrhagic encephalomyelitis (case 2). (A,B) Axial fluid attenuated inversion recovery (FLAIR), (C,D) Susceptibility weighted imaging (SWI), (E,G) Diffusion weighted imaging (DWI), (F,H) Apparent Diffusion coefficient (ADC) sequences, (I,J) T1 post-contrast subtraction images showing bilateral almost symmetrical abnormal diffusion restriction in the thalami and swollen pons, corresponding high FLAIR signal intensity with extensive micro hemorrhages on SWI and diffuse extensive bilateral symmetrical leptomeningeal enhancement involving both cerebellar and cerebral hemispheres.
case_images: qmj-2024-qitc-02-016-g002.jpg
case_images: PMC11046109_01_qmj-2024-qitc-02-016-g002.jpg
case_images: fig2
case_images: Further investigation revealed acute hemorrhagic encephalomyelitis (AHEM) (Figure 2), a rare neurological complication associated with influenza A.
case_images: MRI brain with contrast showing acute hemorrhagic encephalomyelitis (case 3). (A,B) Axial fluid attenuated inversion recovery (FLAIR), (C,D) Susceptibility weighted imaging (SWI), (E,G) Diffusion weighted imaging (DWI), (F,H) Apparent Diffusion coefficient (ADC) sequences, (I,J) T1 post contrast subtraction images showing diffuse brain swelling, increased intra-cranial pressure, scattered white matter, thalamus and brain-stem diffusion restriction, increase FLAIR signals and micro hemorrhages on SWI image along with bilateral leptomeningeal enhancement.
case_images: qmj-2024-qitc-02-016-g003.jpg
case_images: PMC11046109_01_qmj-2024-qitc-02-016-g003.jpg
case_images: fig3
case_images: Imaging showed signs of AHEM (Figure 3), but unlike other similar cases, the patient had only mild respiratory symptoms and no evidence of infection in the cerebrospinal fluid.