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Acute disseminated encephalomyelitis following infectious mononucleosis in a toddler

Hassan Mohsen1, Ghaith Farid Abu Zeinah, Ahmed Hassan Elsotouhy

  • 1Weill Cornell Medical College in Qatar, Doha, Qatar.

BMJ Case Reports
|July 13, 2013
PubMed

Insights

A rare case of acute disseminated encephalomyelitis (ADEM) in a toddler was linked to Epstein-Barr virus (EBV) infection. Prompt treatment led to complete symptom resolution within six weeks.

Area of Science:

  • Pediatrics
  • Infectious Diseases
  • Neurology

Background:

  • Epstein-Barr virus (EBV) is a common viral infection.
  • Acute disseminated encephalomyelitis (ADEM) is a rare neurological complication of infections.
  • ADEM following EBV in toddlers is exceptionally uncommon.

Observation:

  • A 14-month-old boy presented with neurological symptoms after a respiratory illness and amoxicillin rash.
  • Clinical examination revealed drowsiness and throat congestion.
  • Initial investigations showed lymphocytosis, elevated liver enzymes, and positive EBV IgM serology.

Findings:

  • Cerebrospinal fluid analysis indicated pleocytosis.
  • Brain and spine MRI revealed extensive demyelinating lesions characteristic of ADEM.
  • The demyelination extended from the brainstem to the mid-thoracic spinal cord.

Implications:

  • This case highlights the potential for EBV to cause severe neurological complications like ADEM in young children.
  • Early diagnosis and treatment with corticosteroids are crucial for favorable outcomes.
  • Further research may elucidate the specific mechanisms linking EBV to ADEM in pediatric populations.

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