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Acute Disseminated Encephalomyelitis Associated with Pasteurella multocida Meningitis

Published online by Cambridge University Press:  16 December 2016

Normand L. Proulx ,
Mark S. Freedman ,
James W. Chan ,
Baldwin Toye  and
Cathy C. Code
Normand L. Proulx*
Affiliation:
Department of Medicine, Division of Internal Medicine, The Ottawa Hospital – General Campus, Ottawa, Ontario, Canada
Mark S. Freedman
Affiliation:
Division of Neurology, The Ottawa Hospital – General Campus, Ottawa, Ontario, Canada
James W. Chan
Affiliation:
Department of Medicine, Division of Internal Medicine, The Ottawa Hospital – General Campus, Ottawa, Ontario, Canada
Baldwin Toye
Affiliation:
Department of Medicine, Division of Internal Medicine, The Ottawa Hospital – General Campus, Ottawa, Ontario, Canada
Cathy C. Code
Affiliation:
Department of Medicine, Division of Internal Medicine, The Ottawa Hospital – General Campus, Ottawa, Ontario, Canada
*
Blv des Grives #3, Hull, QC J9A 3E4, Canada
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Abstract:

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Objective:

To describe a case of Pasteurella multocida meningitis associated with acute disseminated encephalomyelitis (ADEM).

Case report:

A 33-year-old woman employed in a dog pound presented herself to hospital with fever and meningismus and was found to have culture positive Pasteurella multocida meningitis. Despite appropriate antibiotic treatment her clinical course was characterized by a persistent fever and worsening encephalopathy, which prompted further neurological investigation. Spinal fluid exam and serial MRI scans as well as her one-year clinical course were found to be compatible with ADEM.

Conclusion:

Persistent fever and worsening encephalopathy in meningitis may indicate a para-infectious immune process such as ADEM, and may serve as indications for further neurological investigation.

Résumé:

RÉSUMÉ:Objectif:

Décrire le premier cas connu de méningite à Pasteurella multocida associée à une encéphalomyélite disséminée aiguë (EMDA).

Histoire de cas:

Une femme âgée de 33 ans, travaillant dans une fourrière, s'est présentée à l'hôpital à cause d'une hyperthermie et de méningisme. La culture a montré qu'il s'agissait d'une méningite à Pasteurella multocida. Malgré une antibiothérapie appropriée, la fièvre a persisté et l'encéphalopathie s'est aggravée, ce qui a motivé une investigation neurologique plus poussée. L'examen du liquide céphalo-rachidien et l'IRM ainsi que son évolution clinique sur un an se sont avérés compatibles avec une EMDA.

Conclusion:

Une fièvre persistante et une encéphalopathie qui s'aggrave peuvent être des manifestations d'un processus immunitaire para-infectieux, l'EMDA, compliquant la méningite à Pasteurella multocida. Ce tableau clinique suggère qu'il y a indication de procéder à une investigation neurologique plus poussée.

Type
Case Report
Information
Canadian Journal of Neurological Sciences , Volume 30 , Issue 2 , May 2003 , pp. 155 - 158
Copyright
Copyright © The Canadian Journal of Neurological 2003

References

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