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Neonatal Encephalitis and White Matter Injury in an Early Neonate: Cause or Association With COVID-19 Infection?

Coronavirus disease 2019, caused by severe acute respiratory syndrome coronavirus 2 (SARS CoV-2) has demanded world’s attention. Though this disease affects all age groups, for reasons unknown at this time, neonates and children seem to be at a lower risk of severe infection. We report the first case of neonatal SARS CoV-2 encephalitis in Pune, India and review the related published articles. A 4-day-old, previously healthy, full-term neonate was hospitalized for poor feeding and repeated episodes of focal convulsions since 104 h of life. Keeping in mind the rampant community transmission, SARS-CoV-2 rapid antigen detection and polymerase chain reaction testing was done, where both turned out to be positive. There were elevated inflammatory markers, cerebrospinal fluid pleocytosis, and acute splenial lesions in the magnetic resonance imaging of the brain consistent with neonatal SARS CoV-2 encephalitis. The baby recovered completely with no recurrence and was discharged home in 2 weeks.