Japanese Encephalitis With a Characteristic Neuropathological Distribution Following Early MRI-Based Diagnosis: An Autopsy Case.

Authors

Yujiro Okada, Toshinori Oshima, Keiichi Nakahara, Nasa Okazaki, Fumi Kawakami, Hirotake Nishimura, Hironori Mizutani, Mitsuharu Ueda

Published in

Neuropathology : official journal of the Japanese Society of Neuropathology. Volume 46. Issue 4. Pages e70068.

Abstract

Japanese encephalitis (JE) is a mosquito-borne viral infection of the central nervous system for which no specific antiviral treatment is available. We report the case of a 79-year-old man residing in Kumamoto Prefecture, southwestern Japan, with JE who presented with fever, impaired consciousness, and respiratory failure, and subsequently died of multiple organ failure despite early supportive care. Magnetic resonance imaging (MRI) revealed characteristic bilateral thalamic lesions, leading to an early clinical suspicion of JE before serological confirmation. Neuropathological findings, particularly, the involvement of the thalamus, substantia nigra, hippocampus, and anterior horn of the spinal cord, were consistent with previously reported cases of JE, while also demonstrating a broader distribution of lesions than suggested by antemortem MRI. As most cases of JE occur in unvaccinated individuals, vaccination should be considered in middle-aged and older adults, particularly, those with low antibody titers against the JE virus.

PMID:
42400173
Bibliographic data and abstract were imported from PubMed on 04 Jul 2026.

Read full publication at:
Please sign in to see all details.

Stats

1-terrible, 9-excellent. How would you rate this publication? Sign in in to submit your rating.

Post a comment

You need to be signed in to post comments. You can sign in here.

Comments

There are no comments yet.