An Acute Disseminated Encephalomyelitis Case due to Mycobacterium tuberculosis
Acute disseminated encephalomyelitis (ADEM) is an inflammatory and demyelinating disorder of the central nervous
system that is characterized by multifocal involvement of the white matter. Our patient was a 27-year-old female patient
who had given birth to a baby with caesarean in another hospital. After four days upon the parturition, she was admitted
to our hospital’s general intensive care unit with a poor general status, confusion and a fever. She was diagnosed
with ADEM according to the clinical, laboratory and radiological findings. In addition to her antibiotic treatment (meropenem)
that had been given in the previous health care facility, corticosteroid therapy was also started. The patient
passed away due to the ventilator-associated pneumonia infection on the 10th day of her admission. Mycobacterium
tuberculosis proliferation was observed in the cerebrospinal fluid after her death. As it is reported in literature, tuberculosis
is a rare cause of ADEM. In conclusion, it should be noted that M. tuberculosis can be a rare cause of ADEM in
regions where the disease is endemic. J Microbiol Infect Dis 2016;6(1): 28-31
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- 1. Murthy JM. Acute disseminated encephalomyelitis. Neurol India. 2002;50:238-243.
- 2. Stonehouse B, Gupte G, Wassmer E, Whitehouse WP. Acute disseminated encephalomyelitis: recognition in the hands of general pediatricians. Arch Dis Child. 2003;88:122-124.
- 3. Masoodi I, Farooq O, Ahmad I, et al. Acute disseminated encephalomyelitis as the first presentation of CNS tuberculosis: report of a case with brief review. Ger Med Sci 2010;18;8: Doc32. doi: 10.3205/000121.
- 4. Özhan M, Aydogan ÖT, Kumral E. Acute disseminated encephalomyelitis following pulmonary tuberculosis. Turkish Resp J. 2005;6:161-163.
- 5. van der Knaap MS, Valk J. Acute disseminated encephalomyelitis and acute hemorrhagic encephalomyelitis. In: Magnetic Resonance of Myelination and Myelin Disorders, 3rd edn, Springer, New York. 2005:604.
- 6. Ketelslegers IA, Visser IE, Neuteboom RF, et al. Disease course and outcome of acute disseminated encephalomyelitis is more severe in adults than in children. Mult Scler. 2011;17:441-448.
- 7. Schwarz S, Mohr A, Knauth M, et al. Acute disseminated encephalomyelitis: a follow-up study of 40 adult patients. Neurology. 2001;56:1313-1318.
- 8. Thwaites GE, Tran TH. Tuberculous meningitis: Many questions, too few answers. Lancet Neurol. 2005:4:160-170.
- 9. Cherian A, Thomas SV. Central nervous system tuberculosis. Afr Health Sci. 2011;11:116-125.
- 10. Keegan M, Pineda AA, McClelland RL, et al. Plasma exchange for severe attacks of CNS demyelination: predictors of response. Neurology. 2002;58:143-148.
- 11. Sonneville R, Demeret S, Klein I, et al. Acute disseminated encephalomyelitis in the intensive care unit: clinical features and outcome of 20 adults. Intensive Care Med. 2008;34:528- 532.