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Case report
Aphasia and confusion – influenza encephalopathy: atypical presentation of influenza
  1. Reiichiro Obata1,2 and
  2. Kristina Ernst1
  1. 1Department of Medicine, Icahn School of Medicine at Mount Sinai, Mount Sinai Beth Israel, New York, New York, USA
  2. 2Division of Pulmonary and Critical Care Medicine, Icahn School of Medicine at Mount Sinai, Elmhurst Hospital Center, Elmhurst, New York, USA
  1. Correspondence to Dr Reiichiro Obata; obatar{at}


Influenza encephalopathy, a rare manifestation of influenza infection in the adult population which is not widely recognised, can present with confusion and focal neurological symptoms, including aphasia. The aim of this report is to illustrate the unique presentation of influenza encephalopathy and discuss the need for close attention to and monitoring of this rare but highly fatal disease.

A 28-year-old woman was admitted with acute-onset confusion and incoherent speech. CT of the head was unremarkable. Cerebrospinal fluid analysis showed elevation of protein, but was otherwise unremarkable. A detailed history revealed recent upper respiratory symptoms which prompted a rapid influenza test which was positive and oseltamivir was started. The patient’s confusion and aphasia gradually improved and her speech was back to her baseline by the next day.

  • influenza
  • primary care
  • neurology

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  • Contributors RO wrote the manuscript with the supervision of KE. KE was directly involved in the review and editing process. All authors have read the final version and approved the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.