Influenza A is a highly mutable RNA virus from the Orthomyxoviridae family, and typically presents with upper respiratory tract infections. However, it has occasionally been shown to lead to severe complications, including secondary bacterial infections, widespread inflammatory reactions, and acute hemorrhagic encephalitis. AHE can be seen in patients with severe infection and is associated with devastating neurologic outcomes. Patients develop hemorrhagic necrotizing parenchymal changes on neuro-imaging, with rapidly worsening encephalopathy and coma within the first two weeks of illness. The pathophysiology of this syndrome is hypothesized to occur due to direct viral-mediated endotheliopathy, cytokine storm and blood-brain-barrier dysfunction.