Japanese Encephalitis: A Case of Miraculous Recovery After 68 Days of ICU Admission in a 30 -Years-Old-Male

Background Japanese encephalitis is a disease of central nervous system caused by Japanese Encephalitis Virus (JEV), a flavi virus transmitted by culex mosquitoes. Only <1% of the infected people develop symptoms and among symptomatic cases, around 1/3 ^rd die and remaining 30-50% 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. Case Presentation 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 miraculously recovered fully with no neurological deficits despite severe manifestations on initial presentation. Conclusion This case presents an unusual outcome of JE. Although the prognosis of JE isn’t great, from this case we can say that despite severe presentation we can have favorable outcomes with supportive care and long-term physiotherapy. It’ll 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.