title: Acute disseminating encephalomyelitis following legionnaires disease.
abstract: OBJECTIVE
  To describe 2 patients presenting with severe neurological deficits and extensive lesions on brain magnetic resonance imaging after having experienced Legionella pneumonia.
  
  
  METHODS
  Case reports.
  
  
  METHODS
  University hospital.
  
  
  METHODS
  Two patients who developed severe neurological symptoms, including encephalopathic signs, following Legionella infection, with widespread lesions on magnetic resonance imaging compatible with demyelination.
  
  
  RESULTS
  After extensive ancillary investigations, a diagnosis of acute disseminating encephalomyelitis was considered most likely. Steroid therapy was initiated in 1 of the patients, followed by plasmapheresis. In both patients, clinical and radiological signs gradually recovered, with only slight residual deficits.
  
  
  CONCLUSIONS
  In patients presenting with neurological symptoms after an episode of pneumonia, Legionella infection and a subsequent immune-mediated process such as acute disseminating encephalomyelitis should be considered.
authors.affiliation: Department of Neurology, Erasmus Medical Center, 3000 CA Rotterdam, the Netherlands. l.delau@erasmusmc.nl
authors.forename: Lonneke M L
authors.initials: LM
authors.lastname: de Lau
authors.forename: Dorine A M
authors.initials: DA
authors.lastname: Siepman
authors.forename: Michel J M
authors.initials: MJ
authors.lastname: Remmers
authors.forename: Gisela M
authors.initials: GM
authors.lastname: Terwindt
authors.forename: Rogier Q
authors.initials: RQ
authors.lastname: Hintzen
mesh_terms: D001323:Autoantibodies / Q000097:blood; D001921:Brain / Q000276:immunology / Q000382:microbiology* / Q000473:pathology*; D020278:Demyelinating Autoimmune Diseases, CNS / Q000382:microbiology / Q000473:pathology / Q000503:physiopathology; D003711:Demyelinating Diseases / Q000382:microbiology / Q000473:pathology / Q000503:physiopathology; D004673:Encephalomyelitis, Acute Disseminated / Q000276:immunology / Q000382:microbiology* / Q000473:pathology*; D006801:Humans; D007877:Legionnaires' Disease / Q000150:complications*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010956:Plasmapheresis; D013116:Spinal Cord / Q000276:immunology / Q000382:microbiology* / Q000473:pathology*; D013256:Steroids / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: D001323:Autoantibodies; D013256:Steroids