A man in his 60s presented with a worsening headache, confusion and expressive dysphasia which, on admission, progressed to a falling Glasgow Coma Score and seizures. He was subsequently admitted to the intensive care unit. The clinical diagnosis was antibody-negative autoimmune encephalitis. Despite immunotherapy, the patient died 5 months after initial presentation and postmortem examination revealed he had CD8 encephalitis. This case demonstrates that CD8 encephalitis can present similarly to autoimmune encephalitis both clinically and on imaging. A brain biopsy would have revealed the diagnosis in life, although this would not have altered his treatment.
- HIV / AIDS
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Contributors The case report and discussion were written by ACW and RP with comment on the radiological findings provided by DS and comment on the histopathological findings provided by KA. Radiology and histopathology images were provided by DS and KA, respectively. All authors provided critical feedback on the final version of 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.
Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.
Author note This case is also reported, briefly, as case 23 in Lucas et al HIV-Associated CD8 Encephalitis: A UK Case Series and Review of Histopathologically Confirmed Cases, in Frontiers in Neurology 2021.