Acute disseminated encephalomyelitis following Pontiac fever.
We report the case of a 35-year-old woman who developed headache and psychosis and gradually became comatose within 3 weeks after a flu-like infection. MRI revealed bifrontal demyelination consistent with acute disseminating encephalomyelitis (ADEM). Two different cerebrospinal fluid samples were positively tested for Legionella cincinnatiensis by direct sequencing of a PCR-amplified Legionella-specific fragment. This result made it possible to interpret the initial symptoms as Pontiac fever. We think it most likely that this is a case of ADEM following the very rare situation of a systemic infection with L. cincinnatiensis. A review of the literature on Legionella-associated encephalopathy suggests that some of these cases may also have had ADEM.
Spieker
S
S
Department of Neurology,University of Tübingen, Germany. sybille.spieker@uni-tuebingen.de
Petersen
D
D
Rolfs
A
A
Fehrenbach
F
F
Kuntz
R
R
Seuffer
R H
RH
Fetter
M
M
Dichgans
J
J
D000328:Adult; D004569:Electroencephalography; D004673:Encephalomyelitis, Acute Disseminated / Q000175:diagnosis / Q000382:microbiology*; D005073:Evoked Potentials, Somatosensory; D005260:Female; D005334:Fever / Q000382:microbiology*; D016905:Gram-Negative Bacterial Infections / Q000134:cerebrospinal fluid / Q000382:microbiology; D006801:Humans; D007876:Legionellosis / Q000134:cerebrospinal fluid / Q000382:microbiology; D008279:Magnetic Resonance Imaging; D011149:Pons / Q000382:microbiology / Q000473:pathology*