{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T12:34:23Z","timestamp":1784810063603,"version":"3.55.0"},"reference-count":23,"publisher":"BMJ","issue":"10","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2020,9,10]]},"published-print":{"date-parts":[[2020,10]]},"abstract":"<jats:p>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.<\/jats:p>\n               <jats:p>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\u2019s confusion and aphasia gradually improved and her speech was back to her baseline by the next day.<\/jats:p>","DOI":"10.1136\/bcr-2020-235559","type":"journal-article","created":{"date-parts":[[2020,10,10]],"date-time":"2020-10-10T14:25:19Z","timestamp":1602339919000},"page":"e235559","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Aphasia and confusion \u2013 influenza encephalopathy: atypical presentation of influenza"],"prefix":"10.1136","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1176-081X","authenticated-orcid":false,"given":"Reiichiro","family":"Obata","sequence":"first","affiliation":[{"name":"Department of Medicine, Icahn School of Medicine at Mount Sinai, Mount Sinai Beth Israel, New York, New York, USA"},{"name":"Division of Pulmonary and Critical Care Medicine, Icahn School of Medicine at Mount Sinai, Elmhurst Hospital Center, Elmhurst, New York, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristina","family":"Ernst","sequence":"additional","affiliation":[{"name":"Department of Medicine, Icahn School of Medicine at Mount Sinai, Mount Sinai Beth Israel, New York, New York, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2020,10,10]]},"reference":[{"key":"2025082712141868000_13.10.e235559.1","doi-asserted-by":"crossref","first-page":"308","DOI":"10.1016\/j.hrtlng.2011.06.007","article-title":"Influenza a presenting as viral encephalitis in an adult","volume":"41","author":"Cunha","year":"2012","journal-title":"Heart Lung"},{"key":"2025082712141868000_13.10.e235559.2","doi-asserted-by":"crossref","first-page":"1831","DOI":"10.1093\/cid\/cix1126","article-title":"Characteristics and outcomes of influenza-associated encephalopathy cases among children and adults in Japan, 2010-2015","volume":"66","author":"Okuno","year":"2018","journal-title":"Clin Infect Dis"},{"key":"2025082712141868000_13.10.e235559.3","doi-asserted-by":"crossref","first-page":"e1","DOI":"10.1093\/cid\/ciy866","article-title":"Clinical practice guidelines by the infectious diseases Society of America: 2018 update on diagnosis, treatment, chemoprophylaxis, and institutional outbreak management of seasonal Influenzaa","volume":"68","author":"Uyeki","year":"2019","journal-title":"Clin Infect Dis"},{"key":"2025082712141868000_13.10.e235559.4","doi-asserted-by":"publisher","DOI":"10.1002\/ana.22184"},{"key":"2025082712141868000_13.10.e235559.5","doi-asserted-by":"publisher","DOI":"10.5692\/clinicalneurol.51.422"},{"key":"2025082712141868000_13.10.e235559.6","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(10)70015-6"},{"key":"2025082712141868000_13.10.e235559.7","doi-asserted-by":"publisher","DOI":"10.1016\/j.pediatrneurol.2010.08.011"},{"key":"2025082712141868000_13.10.e235559.8","doi-asserted-by":"publisher","DOI":"10.1016\/S1386-6532(03)00119-7"},{"key":"2025082712141868000_13.10.e235559.9","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0b013e3181ed9cb7"},{"key":"2025082712141868000_13.10.e235559.10","doi-asserted-by":"crossref","first-page":"139","DOI":"10.3201\/eid1601.090007","article-title":"Acute encephalopathy associated with influenza A infection in adults","volume":"16","author":"Lee","year":"2010","journal-title":"Emerg Infect Dis"},{"key":"2025082712141868000_13.10.e235559.11","doi-asserted-by":"publisher","DOI":"10.1086\/367623"},{"key":"2025082712141868000_13.10.e235559.12","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejpn.2004.06.002"},{"key":"2025082712141868000_13.10.e235559.13","doi-asserted-by":"publisher","DOI":"10.1007\/s12028-010-9436-0"},{"key":"2025082712141868000_13.10.e235559.14","first-page":"773","article-title":"Neurologic complications associated with novel influenza A (H1N1) virus infection in children - 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