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

Margherita Di Costanzo1, Maria Erminia Camarca, Maria Giovanna Colella

  • 1Department of Pediatrics, University of Naples "Federico II", Naples, Italy. mara.dicostanzo@live.it

BMC Pediatrics
|November 15, 2011
PubMed
Abstract

Insights

This case report highlights an unusual presentation of acute disseminated encephalomyelitis (ADEM) initially appearing as prolonged fever of unknown origin (FUO) in a pediatric patient.

Area of Science:

  • Neurology
  • Pediatrics
  • Infectious Diseases

Background:

  • Fever of unknown origin (FUO) is defined as elevated body temperature (>38.3°C) for over three weeks with uncertain diagnosis after one week of evaluation.
  • Acute disseminated encephalomyelitis (ADEM) is an inflammatory demyelinating CNS disease with varied clinical presentations, most common in children.
  • ADEM typically follows infections or vaccinations, but can occur without a clear preceding cause.

Observation:

  • A fifteen-year-old boy presented with several weeks of FUO.
  • The initial presentation of ADEM was atypical, manifesting solely as prolonged fever.

Findings:

  • The case demonstrates an unusual initial manifestation of ADEM as FUO.
  • This suggests a potential syndromic association between ADEM and FUO.

Implications:

  • Clinicians should consider ADEM in the differential diagnosis of FUO, particularly in pediatric patients.
  • The presence of even mild neurological or neuropsychiatric symptoms alongside FUO may warrant further investigation for ADEM.

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