Acute disseminating encephalomyelitis following legionnaires disease.
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.
de Lau
Lonneke M L
LM
Department of Neurology, Erasmus Medical Center, 3000 CA Rotterdam, the Netherlands. l.delau@erasmusmc.nl
Siepman
Dorine A M
DA
Remmers
Michel J M
MJ
Terwindt
Gisela M
GM
Hintzen
Rogier Q
RQ
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
D001323:Autoantibodies; D013256:Steroids