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Acute disseminated encephalomyelitis following Tdap vaccination and bacterial meningoencephalitis

J Niederschweiberer1, M Lauerer1, K Schweyer1

  • 1Department of Neurology, Technical University of Munich, School of Medicine, Klinikum rechts der Isar, Munich, Germany.

Multiple Sclerosis and Related Disorders
|September 3, 2020
PubMed
Abstract

Insights

Acute Disseminated Encephalomyelitis (ADEM) can follow bacterial meningitis and Tdap vaccination. This case highlights a rare association between bacterial CNS infection, vaccination, and ADEM development.

Area of Science:

  • Neurology
  • Immunology
  • Infectious Disease

Background:

  • Acute Disseminated Encephalomyelitis (ADEM) is typically linked to viral infections or vaccinations.
  • The association between ADEM and bacterial infections, particularly bacterial meningoencephalitis, is infrequently documented in medical literature.

Observation:

  • A 62-year-old woman developed ADEM following bacterial meningoencephalitis and Tdap vaccination.
  • Initial symptoms included somnolence and meningism, with CSF analysis indicating bacterial meningoencephalitis.
  • Neurological decline recurred, manifesting as aphasia and hemiparesis, with MRI revealing demyelinating lesions.

Findings:

  • Brain biopsy confirmed ADEM, distinct from the initial bacterial meningoencephalitis.
  • Treatment with antibiotics, dexamethasone, and subsequently methylprednisolone led to symptom remission.

Implications:

  • This case suggests that bacterial CNS infections may precipitate ADEM.
  • The preceding Tdap vaccination is hypothesized as a potential contributing factor to ADEM development in this patient.
Keywords:
Acute disseminated encephalomyelitisBacterial meningitisTdapVaccination

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