# Grade IV Glioma Potentially Disguised As COVID-19 Encephalitis

## TL;DR

A patient initially diagnosed with COVID-19 encephalitis was later found to have a grade IV glioma, highlighting the importance of considering rare neurological conditions.

## Contribution

This case report highlights a potential misdiagnosis of grade IV glioma as COVID-19 encephalitis.

## Key findings

- A patient initially diagnosed with stroke and later with temporal lobe encephalitis was found to have a grade IV glioma.
- The patient's initial symptoms and positive PCR test led to treatment for viral encephalitis, but the underlying glioma was undetected.
- This case suggests the need for further investigation into neurological conditions that may mimic COVID-19 encephalitis.

## Abstract

Coronavirus disease 2019 (COVID-19) is caused by the severe acute respiratory distress syndrome coronavirus 2 (SARS-CoV-2), which became a pandemic in March 2020. Since that time, research has shed light on this disease's pulmonary, cardiac, and hematologic complications. However, we are still unraveling the complex neurologic sequelae of COVID-19. Here we present the case of a 58-year-old female who presented with weakness, gaze preference, and aphasia. She was diagnosed with a stroke which was managed medically. The patient returned two weeks later with memory loss and aphasia. An MRI was consistent with temporal lobe encephalitis, although a lumbar puncture was unremarkable. A polymerase chain reaction (PCR) test for COVID-19 was positive. Treatment was initiated for viral encephalitis with patient improvement. She was discharged a second time, and approximately three months later, she presented again with unrelenting headaches. Further imaging revealed a mass that was determined to be a grade IV glioma. Cases of glioma after viral encephalitis have been studied, but a clear link with COVID-19 has not been established.