We present the first described case of Acute disseminated encephalomyelitis (ADEM) in a COVID-19 patient. The clinical features with head CT and brain MRI changes were described. Our described case is an atypical presentation of the novel coronavirus in a young patient and is illustrative of the possible approaches to explore the treatable differential etiologies.

COVID-19 is a new disease caused by the SARS-CoV-2 virus. First described in Wuhan, China, the scope and speed with which the disease has spread has placed healthcare systems around the world under pressure. Afflicted patients typically present with fever, cough, myalgia, and eventually dyspnea. Despite the characteristic presentation of COVID-19, we have frequently noted atypical symptoms including gastrointestinal disturbances and neurological symptoms including headache, altered mental status, loss of olfaction, and seizures. We present the case of a patient who presented with significant neurological symptoms. A right-handed female in her early 40s presented to the emergency department after she developed dysphagia, dysarthria, and encephalopathy 2 days prior to admission. She had a history of well-controlled hypertension and dyslipidemia. The patient had no past medical history of stroke, migraines, visual disturbances, or any neurological disease processes. She had no previous brain imaging studies. There was also no family history of stroke, dementia, migraines with aura, or other neurological disorders. Eleven days prior to admission, the patient began suffering from a headache and myalgia. She was seen by her primary care physician and treated as an outpatient with a course of azithromycin. She had a negative influenza swab and a negative rapid strep test at the office. She was, however, not checked for COVID-19 due to the lack of available testing. The patient's sister, with whom she resided, had recently returned from a trip abroad. The day after returning, the sister developed a headache

We report what we believe is the first case of vertebral osteomyelitis caused by Roseomonas species. The diagnosis of vertebral osteomyelitis can be difficult. The case illustrates the importance of the establishment of an etiologic diagnosis in vertebral osteomyelitis. The features of Roseomonas species and the evaluation of cases of vertebral osteomyelitis are reviewed.

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