A Rare Presentation Of Sepsis Associated Metabolic Encephalopathy With Superadded Uremic Encephalopathy – A Case Report

Authors

  • Sachdev Shobha Pravin
  • Ashwin Kumar Azhagarasan
  • Murugan Gopalakrishnan
  • Vishal Ramnath Chanan

DOI:

https://doi.org/10.63682/jns.v14i14S.4377

Keywords:

Metabolic encephalopathy, Sepsis-associated encephalopathy, Uremic encephalopathy, Lentiform fork sign, White matter disease, Central nervous system, Procalcitonin

Abstract

Background: Sepsis-associated metabolic encephalopathy is seen in critically ill patients. Uremia worsens sepsis, causing significant cognitive and mental status changes.

Objective: To highlight the imaging patterns of septic and uremic encephalopathy.

Methods: The patient was brought to the emergency with decreased responsiveness for 2 days. Comprehensive lab evaluations and imaging studies were conducted.

Results: Imaging diagnosis was made based on the characteristic brain parenchymal changes in correlation with clinical and lab parameters. On follow up post treatment changes revealed resolution of brain parenchymal changes and improved patient’s clinical status.

Discussion: Imaging in septic and metabolic encephalopathy reveals bilateral symmetrical and characteristic changes such as diffuse white matter hyperintensities in brain stem in septic and the Lentiform fork sign in uremic encephalopathy.

Conclusion: Clinicians should correlate lab parameters and imaging patterns with altered mental status to optimize treatment.

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References

Mahoney CA, Sarnacki P, Arieff AI. Uremic encephalopathy: role of brain energy metabolism. Am J Physiol. 1984;247(3 Pt 2).

Olano C, Akram S, Bhatt H. Uremic encephalopathy. 2024. [PubMed].

M. D. G, et al. Metabolic encephalopathy: a review. J Neurol. 2021.

Gofton T, Young G. Sepsis-associated encephalopathy. Nat Rev Neurol. 2012;8:557–66. https://doi.org/10.1038/nrneurol.2012.183.

Kumar G, Goyal MK. Lentiform fork sign: a unique MRI picture. Is metabolic acidosis responsible? Clin Neurol Neurosurg. 2010;112(9):805–12. doi:10.1016/j.clineuro.2010.06.006. [PubMed].

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Published

2025-04-23

How to Cite

1.
Pravin SS, Azhagarasan AK, Gopalakrishnan M, Chanan VR. A Rare Presentation Of Sepsis Associated Metabolic Encephalopathy With Superadded Uremic Encephalopathy – A Case Report. J Neonatal Surg [Internet]. 2025 Apr. 23 [cited 2026 Mar. 10];14(14S):870-2. Available from: https://jneonatalsurg.com/index.php/jns/article/view/4377

Issue

Vol. 14 No. 14S (2025): Journal of Neonatal Surgery

Section

Original Article

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