{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T17:10:55Z","timestamp":1781629855991,"version":"3.54.5"},"reference-count":9,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,1,12]],"date-time":"2026-01-12T00:00:00Z","timestamp":1768176000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,2,9]],"date-time":"2026-02-09T00:00:00Z","timestamp":1770595200000},"content-version":"vor","delay-in-days":28,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Infect Dis"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction and importance<\/jats:title>\n                    <jats:p>Japanese Encephalitis is a disease of central nervous system caused by Japanese Encephalitis Virus (JEV), a flavi virus transmitted by culex mosquitoes. Only\u2009&lt;\u20091% of the infected people develop symptoms and among symptomatic cases, around 1\/3rd die and remaining 30\u201350% develop persisted neurological damage. Here, we present an unusual case of 30 years male with severe neurological manifestations requiring intubation and ICU admission for 68 days but miraculously recovering completely without any residual neurological deficits.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case presentation<\/jats:title>\n                    <jats:p>We present a case of 30 years Male who presented with high grade fever, headache, vomiting which progressed to altered sensorium and decreased GCS requiring intubation. CNS infection was suspected based on presentation and diagnosis of JE was confirmed with CSF anti-JEV IgM ELISA however CNS imaging was not significant. He was managed in ICU for 68 days with supportive care, antibiotics for ventilator associated pneumonia and physiotherapy. On long term follow up on outpatient basis, he unexpectedly recovered fully with no neurological deficits despite severe manifestations on initial presentation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>Japanese Encephalitis, a disease of the CNS, is often asymptomatic, but once a patient becomes symptomatic, it has very bad prognosis with high morbidity and mortality and many patients end up developing lifelong neurological deficits. Our case says otherwise, in which our patient undergoes complete recovery despite severe manifestations on initial presentation. Although this is not the only reported case of recovery from Japanese Encephalitis with severe manifestations at presentation, complete recovery is very rare and this case emphasizes on favorable factors and timely intervention that can help reduce morbidity and mortality in similar cases in the future.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This case presents an unusual outcome of JE. Although the prognosis of JE isn\u2019t great, from this case we can say that despite severe presentation we can have favorable outcomes with supportive care and long-term physiotherapy. It\u2019ll also be helpful while counseling the patient and patient parties on the prognosis of JE. Further research is required to update the outcomes in JE patients in current healthcare settings.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12879-026-12540-2","type":"journal-article","created":{"date-parts":[[2026,1,12]],"date-time":"2026-01-12T12:20:12Z","timestamp":1768220412000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Japanese Encephalitis: a case of remarkable recovery after 68 days of ICU admission in a 30 -years-old-male"],"prefix":"10.1186","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-5276-3494","authenticated-orcid":false,"given":"Bishal","family":"Budha","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ziyaul Haq","family":"Musalman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sabin","family":"Thapaliya","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roshan","family":"Chaudhary","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dhiraj","family":"Adhikari","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sushil","family":"Sah","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dipesh","family":"Regmi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,1,12]]},"reference":[{"issue":"3","key":"12540_CR1","doi-asserted-by":"publisher","first-page":"370","DOI":"10.7416\/ai.2024.2616","volume":"36","author":"PL Lopalco","year":"2024","unstructured":"Lopalco PL, Biasio LR. Japanese encephalitis can be devastating. Ann Ig Med Prev E Comunita. 2024;36(3):370\u20135. https:\/\/doi.org\/10.7416\/ai.2024.2616.","journal-title":"Ann Ig Med Prev E Comunita"},{"issue":"10","key":"12540_CR2","doi-asserted-by":"publisher","first-page":"e0009385","DOI":"10.1371\/journal.pntd.0009385","volume":"15","author":"SM Moore","year":"2021","unstructured":"Moore SM. The current burden of Japanese encephalitis and the estimated impacts of vaccination: combining estimates of the spatial distribution and transmission intensity of a zoonotic pathogen. PLoS Negl Trop Dis. 2021;15(10):e0009385. https:\/\/doi.org\/10.1371\/journal.pntd.0009385.","journal-title":"PLoS Negl Trop Dis"},{"issue":"5","key":"12540_CR3","doi-asserted-by":"publisher","first-page":"125","DOI":"10.31083\/j.jin2105125","volume":"21","author":"H Guo","year":"2022","unstructured":"Guo H, Sun L, Shen X, Hu W. A retrospective study of the clinical characteristics of Japanese encephalitis in adults. J Integr Neurosci. 2022;21(5):125. https:\/\/doi.org\/10.31083\/j.jin2105125.","journal-title":"J Integr Neurosci"},{"key":"12540_CR4","doi-asserted-by":"publisher","unstructured":"Kumar R. Understanding and managing acute encephalitis. F1000Re. 2020;9:F1000 Faculty Rev-60. https:\/\/doi.org\/10.12688\/f1000research.20634.1.","DOI":"10.12688\/f1000research.20634.1"},{"issue":"4","key":"12540_CR5","doi-asserted-by":"publisher","first-page":"2430","DOI":"10.1097\/MS9.0000000000003105","volume":"87","author":"P Basnet","year":"2025","unstructured":"Basnet P, Singh PR, Pudasaini KR, Shrestha S, Kc A. A rare case of symmetric quadriplegia in a patient with Japanese encephalitis: a case report. Ann Med Surg. 2025;87(4):2430. https:\/\/doi.org\/10.1097\/MS9.0000000000003105.","journal-title":"Ann Med Surg"},{"issue":"2","key":"12540_CR6","doi-asserted-by":"publisher","first-page":"263","DOI":"10.4161\/hv.26902","volume":"10","author":"SI Yun","year":"2014","unstructured":"Yun SI, Lee YM. Japanese encephalitis: the virus and vaccines. Hum Vaccines Immunother. 2014;10(2):263\u201379. https:\/\/doi.org\/10.4161\/hv.26902.","journal-title":"Hum Vaccines Immunother"},{"issue":"10","key":"12540_CR7","doi-asserted-by":"publisher","first-page":"6822","DOI":"10.1097\/JS9.0000000000000080","volume":"110","author":"R Sah","year":"2024","unstructured":"Sah R, Mohanty A, Rohilla R, et al. Japanese encephalitis prevalence and outbreaks in Nepal and mitigation strategies: an update on this mosquito-borne zoonotic disease posing public health concerns. Int J Surg. 2024;110(10):6822. https:\/\/doi.org\/10.1097\/JS9.0000000000000080.","journal-title":"Int J Surg"},{"key":"12540_CR8","doi-asserted-by":"publisher","unstructured":"Sharma R, Agarwal M, Saxena SK, et al. Clinical characteristics and differential clinical diagnosis of Japanese encephalitis. In: Saxena SK, editor. Japanese Encephalitis: epidemiology, pathogenesis, diagnosis, and therapeutics. Springer Nature; 2025:p. 85\u2013101. https:\/\/doi.org\/10.1007\/978-981-97-5433-5_8.","DOI":"10.1007\/978-981-97-5433-5_8"},{"issue":"4","key":"12540_CR9","doi-asserted-by":"publisher","first-page":"405","DOI":"10.1136\/jnnp.68.4.405","volume":"68","author":"T Solomon","year":"2000","unstructured":"Solomon T, Dung NM, Kneen R, Gainsborough M, Vaughn D, Khanh VT. Japanese encephalitis. J Neurol Neurosurg Psychiatry. 2000;68(4):405\u201315. https:\/\/doi.org\/10.1136\/jnnp.68.4.405.","journal-title":"J Neurol Neurosurg Psychiatry"}],"container-title":["BMC Infectious Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12879-026-12540-2","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12879-026-12540-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12879-026-12540-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T16:36:45Z","timestamp":1781627805000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1186\/s12879-026-12540-2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,12]]},"references-count":9,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["12540"],"URL":"https:\/\/doi.org\/10.1186\/s12879-026-12540-2","relation":{"has-preprint":[{"id-type":"doi","id":"10.21203\/rs.3.rs-7529089\/v1","asserted-by":"object"}]},"ISSN":["1471-2334"],"issn-type":[{"value":"1471-2334","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,12]]},"assertion":[{"value":"3 September 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"5 January 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"12 January 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval and consent to participate"}},{"value":"Written informed consent was obtained from the patient for publication and any accompanying images. A copy of the written consent is available for review by the Editor-in-Chief of this journal on request.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"293"}}