Skip to main content
Top
Published in: BMC Pediatrics 1/2011

Open Access 01-12-2011 | Case report

Acute disseminated encephalomyelitis presenting as fever of unknown origin: case report

Authors: Margherita Di Costanzo, Maria Erminia Camarca, Maria Giovanna Colella, Giuseppe Buttaro, Andrea Elefante, Roberto Berni Canani

Published in: BMC Pediatrics | Issue 1/2011

Login to get access

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.

Case presentation

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.
Appendix
Available only for authorised users
Literature
1.
go back to reference Williams J, Bellamy R: Fever of unknown origin. Clin Med. 2008, 8 (Suppl 5): 526-30. Williams J, Bellamy R: Fever of unknown origin. Clin Med. 2008, 8 (Suppl 5): 526-30.
2.
go back to reference Chiappini E, Galli L, Bonsignori F, Venturini E, Principi N, de Martino M: Self-reported pediatricians' management of the well-appearing young child with fever without a source: first survey in an European country in the anti-pneumococcal vaccine era. BMC Public Health. 2009, 9: 300-10.1186/1471-2458-9-300.CrossRefPubMedPubMedCentral Chiappini E, Galli L, Bonsignori F, Venturini E, Principi N, de Martino M: Self-reported pediatricians' management of the well-appearing young child with fever without a source: first survey in an European country in the anti-pneumococcal vaccine era. BMC Public Health. 2009, 9: 300-10.1186/1471-2458-9-300.CrossRefPubMedPubMedCentral
3.
go back to reference Menge T, Kieseier BC, Nessler S, Hemmer B, Hartung HP, Stüve O: Acute disseminated encephalomyelitis: an acute hit against the brain. Curr Opin Neurol. 2007, 20 (Suppl 3): 247-54.CrossRefPubMed Menge T, Kieseier BC, Nessler S, Hemmer B, Hartung HP, Stüve O: Acute disseminated encephalomyelitis: an acute hit against the brain. Curr Opin Neurol. 2007, 20 (Suppl 3): 247-54.CrossRefPubMed
4.
go back to reference Marchioni E, Tavazzi E, Minoli L, Del Bue S, Ferrante P, Piccolo G, Bastianello S, Ravaglia S: Acute disseminated encephalomyelitis. Neurol Sci. 2008, 29 (Suppl 2): S286-8.CrossRefPubMed Marchioni E, Tavazzi E, Minoli L, Del Bue S, Ferrante P, Piccolo G, Bastianello S, Ravaglia S: Acute disseminated encephalomyelitis. Neurol Sci. 2008, 29 (Suppl 2): S286-8.CrossRefPubMed
5.
go back to reference Young NP, Weinshenker BG, Lucchinetti CF: Acute Disseminated Encephalomyelitis: Current Understanding and Controversies. Semin Neurol. 2008, 28: 84-94. 10.1055/s-2007-1019130.CrossRefPubMed Young NP, Weinshenker BG, Lucchinetti CF: Acute Disseminated Encephalomyelitis: Current Understanding and Controversies. Semin Neurol. 2008, 28: 84-94. 10.1055/s-2007-1019130.CrossRefPubMed
6.
go back to reference Hynson JL, Kornberg AJ, Coleman LT, Shield L, Harvey AS, Kean JM: Clinical and neuroradiologic features of acute disseminated encephalomyelitis in children. Neurology. 2001, 56: 1308-12.CrossRefPubMed Hynson JL, Kornberg AJ, Coleman LT, Shield L, Harvey AS, Kean JM: Clinical and neuroradiologic features of acute disseminated encephalomyelitis in children. Neurology. 2001, 56: 1308-12.CrossRefPubMed
7.
go back to reference La Mantia L, Erbetta A: Headache and inflammatory disorders of the central nervous system. Neurol Sci. 2004, 25 (Suppl 3): S148-53.CrossRefPubMed La Mantia L, Erbetta A: Headache and inflammatory disorders of the central nervous system. Neurol Sci. 2004, 25 (Suppl 3): S148-53.CrossRefPubMed
8.
go back to reference Ravaglia S, Piccolo G, Ceroni M, Franciotta D, Pichiecchio A, Bastianello S, Tavazzi E, Minoli L, Marchioni E: Severe steroid-resistant post-infectious encephalomyelitis: general features and effects of IVIg. J Neurol. 2007, 254 (Suppl 11): 1518-23.CrossRefPubMed Ravaglia S, Piccolo G, Ceroni M, Franciotta D, Pichiecchio A, Bastianello S, Tavazzi E, Minoli L, Marchioni E: Severe steroid-resistant post-infectious encephalomyelitis: general features and effects of IVIg. J Neurol. 2007, 254 (Suppl 11): 1518-23.CrossRefPubMed
10.
go back to reference Tenembaum S, Chitnis T, Ness J, Hahn JS, International Pediatric MS Study Group: Acute disseminated encephalomyelitis. Neurology. 2007, 68 (16 Suppl 2): S23-36.CrossRefPubMed Tenembaum S, Chitnis T, Ness J, Hahn JS, International Pediatric MS Study Group: Acute disseminated encephalomyelitis. Neurology. 2007, 68 (16 Suppl 2): S23-36.CrossRefPubMed
11.
go back to reference Leake JA, Albani S, Kao AS, Senac MO, Billman GF, Nespeca MP, Paulino AD, Quintela ER, Sawyer MH, Bradley JS: Acute disseminated encephalomyelitis in childhood: epidemiologic, clinical and laboratory features. Pediatr Infect Dis J. 2004, 23 (Suppl 8): 756-64.CrossRefPubMed Leake JA, Albani S, Kao AS, Senac MO, Billman GF, Nespeca MP, Paulino AD, Quintela ER, Sawyer MH, Bradley JS: Acute disseminated encephalomyelitis in childhood: epidemiologic, clinical and laboratory features. Pediatr Infect Dis J. 2004, 23 (Suppl 8): 756-64.CrossRefPubMed
Metadata
Title
Acute disseminated encephalomyelitis presenting as fever of unknown origin: case report
Authors
Margherita Di Costanzo
Maria Erminia Camarca
Maria Giovanna Colella
Giuseppe Buttaro
Andrea Elefante
Roberto Berni Canani
Publication date
01-12-2011
Publisher
BioMed Central
Published in
BMC Pediatrics / Issue 1/2011
Electronic ISSN: 1471-2431
DOI
https://doi.org/10.1186/1471-2431-11-103

Other articles of this Issue 1/2011

BMC Pediatrics 1/2011 Go to the issue