Late Ebola virus relapse causing meningoencephalitis: a case report

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Late Ebola virus relapse causing meningoencephalitis: a case report Dr Michael Jacobs, FRCP, Alison Rodger, FRCP, David J Bell, MRCP, Sanjay Bhagani, FRCP, Ian Cropley, FRCP, Ana Filipe, PhD, Robert J Gifford, PhD, Susan Hopkins, FRCP, Joseph Hughes, PhD, Farrah Jabeen, FRCR, Ingolfur Johannessen, FRCPath, Drosos Karageorgopoulos, MRCP, Angie Lackenby, PhD, Rebecca Lester, MRCP, Rebecca S N Liu, FRCP, Alisdair MacConnachie, MRCP, Tabitha Mahungu, MRCP, Daniel Martin, FRCA, Neal Marshall, MRPharmS, Stephen Mepham, FRCPath, Richard Orton, PhD, Prof Massimo Palmarini, PhD, Monika Patel, MSc, Colin Perry, FRCP, S Erica Peters, MRCP, Duncan Porter, MD, David Ritchie, FRCR, Neil D Ritchie, MRCP, R Andrew Seaton, FRCP, Vattipally B Sreenu, PhD, Kate Templeton, FRCPath, Simon Warren, FRCPath, Gavin S Wilkie, PhD, Maria Zambon, FRCPath, Robin Gopal, PhD, Emma C Thomson, FRCP The Lancet Volume 388, Issue 10043, Pages 498-503 (July 2016) DOI: 10.1016/S0140-6736(16)30386-5 Copyright © 2016 Elsevier Ltd Terms and Conditions

Figure 1 Clinical laboratory findings over the course of Ebola virus relapse RT-PCR=reverse transcriptase PCR. The Lancet 2016 388, 498-503DOI: (10.1016/S0140-6736(16)30386-5) Copyright © 2016 Elsevier Ltd Terms and Conditions

Figure 2 Contrast-enhanced MRI of the head and spine Gadolinium-enhanced, fat-suppressed, 3 mm axial T1-weighted images of the brain showing: abnormal area of enhancement within the left cerebellar hemisphere (black arrow) and abnormal enhancement of the left cochlea basal turn (red arrow; A); and abnormal enhancement within the left cerebellar hemisphere (black arrow), right cochlea basal turn (red arrow), anterior genu of the tympanic segment of the left facial nerve (blue arrow), and focus of enhancement within the left internal auditory canal (orange arrow; B). Gadolinium-enhanced 4 mm sagittal T1-weighted image of the lumbar spine showing enhancement involving the surface of conus and along the cauda equina (green arrow; C). The Lancet 2016 388, 498-503DOI: (10.1016/S0140-6736(16)30386-5) Copyright © 2016 Elsevier Ltd Terms and Conditions