title: Marburg's disease: a diagnostic dilemma.
abstract: This report describes the clinical, radiological and autopsy findings of a young male suffering from acute, monophasic demyelinating disease presenting with acute onset of altered sensorium and a short past history of progressive multiple neurological deficits. The radiological findings revealed acute infarcts in the territory of anterior cerebral artery. The antemortem diagnosis centred on an infective (tubercular) aetiology leading to demyelination based on presence of tubercle bacilli in bronchoalveolar lavage (BAL) fluid. The autopsy revealed multiple subacute and acute plaques showing demyelination, giant astrocytes, numerous macrophages and little perivascular inflammation, thereby confirming the diagnosis of Marburg's type of multiple sclerosis. Marburg's type is a fulminant demyelinating disorder characterised by a severe, rapidly evolving clinical course. Death occurs due to brain stem involvement or severe widespread cerebral lesions.
authors.affiliation: Department of Histopathology, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh 160012, India. kirtigupta10@yahoo.co.in
authors.forename: Kirti
authors.initials: K
authors.lastname: Gupta
authors.forename: Rakesh Kumar
authors.initials: RK
authors.lastname: Vasishta
authors.forename: Param Singh
authors.initials: PS
authors.lastname: Kharbanda
authors.forename: Sameer
authors.initials: S
authors.lastname: Vyas
authors.forename: Sudesh
authors.initials: S
authors.lastname: Prabhakar
mesh_terms: D000208:Acute Disease; D000328:Adult; D000818:Animals; D001344:Autopsy; D001921:Brain / Q000473:pathology*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D009103:Multiple Sclerosis / Q000175:diagnosis*