An Acute Disseminated Encephalomyelitis Case due to Mycobacterium tuberculosis

Abstract

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

Unusual case of cerebral demyelination and bilateral optic neuritis in an infant with suppurative BCG lymphadenitis

“…In contrast, tuberculous meningitis commonly present as hydrocephalus, basal meningeal enhancement and parenchymal abnormalities such as tuberculomas, abscesses and infarctions 3. Our patient’s brain imaging was congruent with classical neuroimaging features of ADEM.…”

“…Though the exact mechanism of demyelination is unknown, it is postulated to occur due to a cross-reaction between the triggering infectious agents and the neural tissue 3. Our patient presented 1 month following the onset of axillary lymphadenitis with encephalopathy, motor deficits and optic neuritis.…”