Acute Disseminated Encephalomyelitis in a Child with Staphylococcus aureus Bacteremia and Septic Arthritis

Excerpt

To the Editor: A 13-y-old boy presented with fever, altered sensorium and seizure; he also had right knee swelling and pain, which started four days before the fever. At presentation, he had features of Upper motor neuron lesion and encephalopathy. The knee examination was suggestive of septic arthritis; however, aspiration was not possible due to lack of consent. His blood culture was positive for methicillin-sensitive S. aureus, but CSF microscopy and biochemistry were normal, and the culture was sterile. MRI brain revealed acute disseminated encephalomyelitis in bilateral frontoparietal lobe (Supplementary Fig. S1). IV methyl prednisolone was given for five days. After one pulse, he had significant improvement. His serum MOG antibodies were negative. Septic arthritis was treated with IV ceftriaxone, as repeat blood culture was sterile; he was switched on day 10 to oral cloxacillin to complete three weeks as the isolate was sensitive to the same. The child was discharged with complete clinical recovery on oral prednisolone. …