title: Acute disseminated encephalomyelitis following Campylobacter jejuni gastroenteritis: Case report and review of the literature.
abstract: We describe a case of a 25-year-old male with a diagnosis of acute disseminated encephalomyelitis (ADEM) following infection with Campylobacter jejuni, which is implicated in various human pathologies regarding the central nervous system (CNS) with acute course like Guillain-Barré syndrome (GBS), Miller-Fisher syndrome (MFS), Bickerstaff's brainstem encephalitis (BEE), acute transverse myelitis (ATM) as well as ADEM. These conditions are caused by cross-reactivity between Campylobacter's epitopes and cells of the CNS that causes an immunomediated inflammatory demyelination of the CNS. In the acute phase, magnetic resonance (MR) can detect pathologic signal intensity at the CNS with areas of pathologic contrast enhancement at cortical and spinal white matter that normalize over time or can be stable. These findings can be associated with edema in parts of the CNS. The lesions typically appear at different times during the disease course and also can have a different evolution. Our purpose therefore was to describe the clinical course and MR findings of this case and perform a critical review of the literature.
authors.affiliation: 1 Neuroradiology COU, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Italy.
authors.forename: Simone
authors.initials: S
authors.lastname: Marziali
authors.affiliation: 1 Neuroradiology COU, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Italy.
authors.forename: Eliseo
authors.initials: E
authors.lastname: Picchi
authors.affiliation: 1 Neuroradiology COU, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Italy.
authors.forename: Francesca
authors.initials: F
authors.lastname: Di Giuliano
authors.affiliation: 1 Neuroradiology COU, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Italy.
authors.forename: Simone
authors.initials: S
authors.lastname: Altobelli
authors.affiliation: 2 Neurology COU, Department of Systems Medicine, University of Rome Tor Vergata, Italy.
authors.forename: Giorgia
authors.initials: G
authors.lastname: Mataluni
authors.affiliation: 2 Neurology COU, Department of Systems Medicine, University of Rome Tor Vergata, Italy.
authors.forename: Girolama
authors.initials: G
authors.lastname: Marfia
authors.affiliation: 1 Neuroradiology COU, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Garaci
authors.affiliation: 1 Neuroradiology COU, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Floris
mesh_terms: D000328:Adult; D002169:Campylobacter Infections / Q000150:complications*; D016123:Campylobacter jejuni / Q000472:pathogenicity*; D004673:Encephalomyelitis, Acute Disseminated / Q000000981:diagnostic imaging / Q000209:etiology* / Q000382:microbiology; D005759:Gastroenteritis / Q000150:complications* / Q000000981:diagnostic imaging / Q000209:etiology* / Q000382:microbiology; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008297:Male; D013116:Spinal Cord / Q000000981:diagnostic imaging
keywords: ADEM; CSF; Campylobacter jejuni; MRI; gastrointestinal infection; immuno-mediated reaction