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TIMELY EMERGENCY TREATMENT FOR A 17-YEAR-OLD PATIENT WITH A RARE AUTOIMMUNE ENCEPHALITIS

TIMELY EMERGENCY TREATMENT FOR A 17-YEAR-OLD PATIENT WITH A RARE AUTOIMMUNE ENCEPHALITIS

17/09/2025

On July 1, 2025, the Emergency Department of the American International Hospital (AIH) received a special case: patient H.N.T., born in 2008, was transferred to AIH in a condition where they could open their eyes spontaneously but were unresponsive to the surroundings, presented with generalized muscle rigidity, involuntary movements, high fever of 39°C, and tachycardia.

According to the family, about three weeks earlier, after experiencing a psychological event, the patient showed signs of depression, loss of motivation in studying and working. The patient had been taken to several local medical facilities for treatment, but the condition did not improve, and was later transferred to the American International Hospital (AIH).

Upon admission, the initial diagnosis was purulent meningoencephalitis, with viral encephalitis not ruled out. The patient was treated with broad-spectrum antibiotics, antiviral medication, and intensive resuscitation measures. However, their condition showed no improvement. After three days of treatment, both blood and cerebrospinal fluid tests were negative for all viruses and bacteria, and a brain MRI revealed no abnormalities. This posed a significant diagnostic challenge, prompting the medical team to consider a rarer cause — autoimmune encephalitis.

The ICU doctors immediately consulted and further discussed the case with leading specialists in Psychiatry and Neurology. The treatment strategy was shifted toward autoimmune encephalitis. Doctors initiated high-dose corticosteroid therapy and intravenous immunoglobulin, repeated infection tests, and conducted an autoimmune antibody panel.

After two courses of corticosteroids and intravenous immunoglobulin, the patient’s condition showed significant improvement: the fever subsided, they began to open their eyes and respond to stimuli, and the seizures gradually decreased and eventually disappeared completely. However, subsequent test results remained negative for viruses, bacteria, and common autoimmune markers. The patient was diagnosed with seronegative autoimmune encephalitis and continued maintenance therapy with corticosteroids, combined with motor rehabilitation, and social and family reintegration under the close supervision of ICU doctors and nurses. The patient gradually recovered, regaining basic functions such as communicating with relatives, showing progressive motor improvement, and being able to eat independently by mouth.

After three weeks of treatment, the patient was discharged in a conscious state, able to walk and perform personal activities with assistance, without fever, muscle rigidity, or seizures. Although the acute phase had passed, they will continue long-term immunosuppressive therapy and management for potential encephalitis-related sequelae.    

Autoimmune encephalitis is a rare and difficult-to-diagnose disease, with an incidence of approximately four cases per one million people per year. The pathogenesis occurs when the body’s antibodies mistakenly attack healthy brain cells. The causes may include infections, viral illnesses, or the use of certain medications such as monoclonal antibodies or immunosuppressants. Without timely diagnosis and treatment, the disease can lead to severe neurological sequelae or even death. Some patients may experience prolonged symptoms, with full recovery taking several months to several years. In particular, many cases may continue to face cognitive and behavioral issues for more than a year.

American International Hospital (AIH) provides professional 24/7 emergency services, ready to respond promptly in any situation:

  • Emergency hotline *1155 – fast and timely.

  • Ambulances equipped with modern international-standard facilities, ensuring timely first aid during patient transport.

  • Highly skilled emergency team with experience working at major hospitals and international emergency organizations such as International SOS.

  • Standardized and professional emergency procedures.

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AMERICAN INTERNATIONAL HOSPITAL (AIH):
☎ Hotline: 1900 3399 || (028) 3910 9999​
🌏 Website: www.aih.com.vn
📍Address: (Entrance from 199 Nguyen Hoang Street) No.6, Bac Nam 3 Street, Binh Trung Ward, Ho Chi Minh
  • by Admin AIH
  • In Tin tức & Sự kiện

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