Influenza Infection Causing Manic Psychosis

Abstract

Although depression is well known as a sequel to influenza, mania is not. We describe a patient with a severe psychotic illness who first showed features of a confusional state but then developed a manic psychosis. The occurrence of functional affective psychoses during or following systemic physical illness has been well described (Bonhoeffer, 1909; Kraepelin, 1921; Kiloh, 1961; Post, 1965), but the nature of the relationship has never been clear. In some instances, the physical illness may simply act as a form of non-specific stress precipitating the mental disorder; evidence for a more direct patho-physiological relationship has been lacking. When, in addition to a background of physical illness, a patient shows disorientation and clouding of consciousness together with signs of a manic psychosis, the diagnostic problem is especially difficult, particularly so since a confusional state can occur as part of a severe manic illness (Maudsley, 1895; Kraepelin, 1921). Conversely, hypomanic symptoms can occur in an organic psychosis (Bonhoeffer, 1909).

Acute influenza virus-associated encephalitis and encephalopathy in adults: a challenging diagnosis

“…2. In total, 44 cases of IAE in adults were identified from 31 reports (Ak et al , 2012; Akins et al , 2010; Alakare et al , 2010; Bartynski et al , 2009; Bulakbasi et al , 2006; Chen et al , 2010; Cheng et al , 2011; Cunha et al , 2012; Fukami et al , 2005; Gadoth et al , 2010; Goenka et al , 2014; Gonzalez & Brust, 2009; Hakoda & Nakatani, 2000; Hawkins et al , 1987; Hjalmarsson et al , 2009; Iijima et al , 2002; Ishii et al , 2015; Ito et al , 2011; Jeganathan et al , 2013; Khosla et al , 2011; Kimura et al , 2008; Lee et al , 2010; Salonen et al , 1997; Santini et al , 2012; Simon et al , 2013; Steinberg et al , 1972; Steininger et al , 2003; Tsai et al , 2011; Wang et al , 2011, 2015; Yamashita et al , 2008). The cases are summarized in the supplementary material.…”

Association of seropositivity for influenza and coronaviruses with history of mood disorders and suicide attempts

“…Harrison (1958) described a series of 37 cases of postinfluenza depression in Kent, England. Influenza has also been reported to be associated with the onset of a manic episode in individuals with no previous history of mental illness (Steinberg et al, 1972;Maurizi, 1985). These case reports notwithstanding, there is still a need to systematically examine the possible relationship between neurotropic respiratory viruses, mood disorders and suicide attempts.…”

Altered White Cell Count, Protein Concentration and Oligoclonal IgG Bands in the Cerebrospinal Fluid of Many Patients with Acute Psychiatric Disorders

“…For example, acute encephalitis may resemble acute catatonic or paranoid psychosis [1][2][3], and even some severe cases of mania have in fact proved to be caused by infection with herpes simplex virus (HSV), Coxiella burnetii (Q-fever) or influenza vi rus affecting directly or indirectly the central nervous sys tem (CNS) [4][5][6]. Furthermore, there are suggestions pro posing that viruses or virus-like agents may have a signif icant role in the aetiology and pathogenesis of at least some of the so-called functional psychiatric disorders [7][8][9][10].…”