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[Acute meningoencephalitis caused by Streptococcus pneumoniae, mimicking acute disseminated encephalomyelitis]

Juri Kureshiro1, Yoshimasa Kuzumoto, Hiromi Aomatsu

  • 1Department of Neurology, Kinki University School of Medicine.

Rinsho Shinkeigaku = Clinical Neurology
|May 6, 2008
PubMed

Insights

Streptococcus pneumoniae can cause meningoencephalitis, mimicking acute disseminated encephalomyelitis (ADEM). Prompt treatment with antibiotics and steroids resolved symptoms and brain lesions in a unique case.

Area of Science:

  • Neurology
  • Infectious Diseases
  • Neuroimmunology

Background:

  • Streptococcus pneumoniae is a common cause of bacterial meningitis.
  • Meningoencephalitis involves inflammation of the brain and meninges.
  • Acute disseminated encephalomyelitis (ADEM) is an immune-mediated demyelinating disease.

Observation:

  • A 57-year-old woman presented with fever, headache, and meningeal irritation.
  • Cerebrospinal fluid analysis revealed polymorphonuclear pleocytosis, and Streptococcus pneumoniae was identified.
  • Brain MRI showed white matter lesions suggestive of demyelination.

Findings:

  • The patient was diagnosed with pneumococcal meningoencephalitis.
  • Initial treatment with meropenem improved clinical symptoms but not MRI findings.
  • Intravenous methylprednisolone pulse therapy led to neurological recovery and resolution of brain lesions.

Implications:

  • Pneumococcal infection can trigger an ADEM-like syndrome.
  • This case highlights the potential role of infections in ADEM pathogenesis.
  • Early diagnosis and combined antibiotic and immunomodulatory therapy are crucial for managing severe pneumococcal meningoencephalitis.

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