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


METHODS
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.


CONCLUSIONS
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.
Proulx
Normand L
NL
Department of Medicine, Division of Internal Medicine, The Ottawa Hospital-General Campus, Ottawa, Ontario, Canada.
Freedman
Mark S
MS
Chan
James W
JW
Toye
Baldwin
B
Code
Cathy C
CC
D000208:Acute Disease; D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D004673:Encephalomyelitis, Acute Disseminated / Q000382:microbiology*; D005260:Female; D006261:Headache / Q000382:microbiology / Q000473:pathology / Q000503:physiopathology; D006801:Humans; D008279:Magnetic Resonance Imaging; D016920:Meningitis, Bacterial / Q000150:complications* / Q000382:microbiology*; D010326:Pasteurella Infections / Q000473:pathology* / Q000503:physiopathology; D016979:Pasteurella multocida / Q000472:pathogenicity*; D012894:Sleep Stages / Q000276:immunology; D013687:Telencephalon / Q000382:microbiology / Q000473:pathology / Q000503:physiopathology; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents