Acute meningoencephalitis caused by streptococcus pneumoniae, mimicking acute disseminated encephalomyelitis

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  • 急性散在性脳脊髄炎様病態を続発した，肺炎球菌性髄膜脳炎の１例
  • 症例報告 急性散在性脳脊髄炎様病態を続発した,肺炎球菌性髄膜脳炎の1例
  • ショウレイ ホウコク キュウセイ サンザイセイ ノウ セキズイエンヨウ ビョウタイ オ ゾクハツシタ ハイエン キュウキンセイ ズイマク ノウエン ノ 1レイ

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Abstract

A 57-year old woman had a five-day history of cough and high fever followed by abnormal behavior and headache with signs of meningeal irritation. A cerebrospinal fluid (CSF) exam revealed polymorphonuclear pleocytosis. Streptococcus pneumoniae was cultured from the patient's CSF and serum. Clinical features and laboratory investigations supported a diagnosis of pneumococcal meningoencephalitis. After treatment with intravenous meropenem (MEPM), the patient's laboratory data improved and her neck stiffness disappeared, but a brain MRI showed white matter lesions in the bilateral frontal and temporal lobes. The patient responded to pulse therapy with intravenous methylprednisolone (1g/day), carried out over three days: she recovered neurological function and her MRI lesions resolved.<br> We report a case of acute meningoencephalitis caused by Streptococcus pneumoniae, mimicking acute disseminated encephalomyelitis (ADEM). We suggest that pneumococcal infection is one of the pathogenetic factors in ADEM.<br>

Journal

  • Rinsho Shinkeigaku

    Rinsho Shinkeigaku 48 (4), 255-258, 2008

    Societas Neurologica Japonica

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