Acute disseminated encephalomyelitis following pleural empyema owing to Boerhaave's syndrome.
Acute disseminated encephalomyelitis is reported in a 14-year-old male patient associated with a pleural empyema caused by an esophageal perforation. During the hospital course, the patient experienced an episode of cardiac arrest, raising the question of hypoxic-ischemic cerebral injury, but the magnetic resonance imaging (MRI) findings and clinical course were most consistent with acute disseminated encephalomyelitis. After a course of methylprednisolone, broad-spectrum antibiotics, and bilateral chest tube placement, the patient recovered with only mild residual deficits, along with resolution of his MRI findings.
Varilek
Bradette Z
BZ
University of Nebraska, College of Medicine, Omaha, USA.
Larsen
Paul D
PD
Wright
Rhonda R
RR
Chatterjee
Archana
A
Knapp
Hilary K
HK
D000293:Adolescent; D000900:Anti-Bacterial Agents; D002177:Candidiasis / Q000175:diagnosis / Q000188:drug therapy; D002540:Cerebral Cortex / Q000473:pathology; D015505:Chest Tubes; D003937:Diagnosis, Differential; D004359:Drug Therapy, Combination / Q000627:therapeutic use; D016124:Eikenella corrodens / Q000187:drug effects; D004569:Electroencephalography; D016724:Empyema, Pleural / Q000175:diagnosis* / Q000188:drug therapy; D004673:Encephalomyelitis, Acute Disseminated / Q000175:diagnosis* / Q000188:drug therapy; D004939:Esophageal Perforation / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D005500:Follow-Up Studies; D005517:Foodborne Diseases / Q000150:complications; D016905:Gram-Negative Bacterial Infections / Q000175:diagnosis / Q000188:drug therapy; D006323:Heart Arrest / Q000209:etiology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008775:Methylprednisolone / Q000627:therapeutic use; D009460:Neurologic Examination / Q000187:drug effects; D012151:Resuscitation; D013290:Streptococcal Infections / Q000175:diagnosis / Q000188:drug therapy; D013297:Streptococcus pyogenes / Q000187:drug effects; D013577:Syndrome; D014678:Veillonella / Q000187:drug effects
D000900:Anti-Bacterial Agents; D008775:Methylprednisolone