title: Acute disseminated encephalomyelitis presenting as fever of unknown origin: case report.
abstract: BACKGROUND
  Fever of unknown origin (FUO) can be defined as a body temperature higher than 38.3°C on several occasions over more than 3 weeks, the diagnosis of which remains uncertain after 1 week of evaluation. Acute disseminated encephalomyelitis (ADEM) is an inflammatory demyelinating disease of the central nervous system with a wide range of clinical manifestations. The highest incidence of ADEM is observed during childhood and it usually occurs following a viral or bacterial infection or, more rarely, following a vaccination, or without a preceding cause.
  
  
  METHODS
  Here, we describe an atypical case of ADEM that initially manifested as several weeks of FUO in a fifteen years old boy.
  
  
  CONCLUSIONS
  This case report suggests a new possible syndromic association between ADEM and FUO, which should be considered in the clinical examination of patients with FUO, especially in the presence of also modest neurologic or neuropsychiatric symptoms.
authors.affiliation: Department of Pediatrics, University of Naples "Federico II", Naples, Italy. mara.dicostanzo@live.it
authors.forename: Margherita Di
authors.initials: MD
authors.lastname: Costanzo
authors.forename: Maria Erminia
authors.initials: ME
authors.lastname: Camarca
authors.forename: Maria Giovanna
authors.initials: MG
authors.lastname: Colella
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Buttaro
authors.forename: Andrea
authors.initials: A
authors.lastname: Elefante
authors.forename: Roberto Berni
authors.initials: RB
authors.lastname: Canani
mesh_terms: D003937:Diagnosis, Differential; D004673:Encephalomyelitis, Acute Disseminated / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D005335:Fever of Unknown Origin / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D005500:Follow-Up Studies; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D014057:Tomography, X-Ray Computed; D055815:Young Adult
chemical_list: D005938:Glucocorticoids
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