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Madariaga virus infection associated with a case of acute disseminated encephalomyelitis

Kathia Luciani1, Iván Abadía1, Alex O Martínez-Torres1

  • 1Division of Pediatric Infection Disease and Division of Pediatric Neurology, Hospital del Niño, Panama City, Panama; Department of Research in Virology and Biotechnology, Gorgas Memorial Institute of Health Studies, Panama City, Panama; School of Medicine, Columbus University, Panama City, Panama; Department of Microbiology and Parasitology, University of Panama, Panama City, Panama.

The American Journal of Tropical Medicine and Hygiene
|April 15, 2015
PubMed

Insights

This report details a pediatric case of acute disseminated encephalomyelitis (ADEM) linked to Madariaga virus infection (MADV). MADV should be considered in ADEM differential diagnoses in endemic regions.

Area of Science:

  • Neuroscience
  • Virology
  • Pediatrics

Background:

  • Acute disseminated encephalomyelitis (ADEM) is an immune-mediated inflammatory demyelinating disease of the central nervous system.
  • Madariaga virus (MADV), an Alphavirus, has been associated with neurological disease outbreaks in South America.

Observation:

  • A pediatric patient presented with ADEM symptoms during a 2010 MADV epidemic in Panama.
  • Clinical manifestations included decreased alertness, disorientation, hemiparesis, and a left Babinski sign.
  • Brain MRI revealed multiple cortical-subcortical hyperintense lesions on T2 and FLAIR sequences.

Findings:

  • Cerebrospinal fluid analysis and serological tests confirmed immunoglobulin M (IgM) positivity for MADV.
  • The patient's clinical presentation, neuroimaging, and serological results supported the diagnosis of MADV-associated ADEM.
  • Rapid symptom progression and characteristic neuroimaging findings were noted.

Implications:

  • This case highlights MADV as a potential etiological agent for ADEM in pediatric populations.
  • MADV should be included in the differential diagnosis of ADEM in endemic areas.
  • Further research is warranted to understand the pathogenesis of MADV-induced neurological complications.

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