A rare etiology of mild encephalitis/encephalopathy with reversible splenial lesion

Hiroki Shimono1, Yoji Hoshina2, Ei Ogawa3

  • 1Center for Clinical Education and Training Takamatsu Red Cross Hospital Takamatsu Japan.

Clinical Case Reports
|September 6, 2021
PubMed

Insights

Legionella bacteria can cause a rare, mild brain inflammation (encephalitis) with temporary MRI changes. Consider Legionella in at-risk patients, as standard spinal fluid tests may be normal.

Area of Science:

  • Neurology
  • Infectious Diseases

Background:

  • Encephalitis/encephalopathy is inflammation of the brain.
  • Legionella is an uncommon cause of central nervous system infections.

Purpose of the Study:

  • To highlight Legionella as a potential cause of mild encephalitis/encephalopathy.
  • To emphasize the diagnostic utility of specific tests in suspected cases.

Main Methods:

  • Case review and literature analysis.
  • Brain magnetic resonance imaging (MRI) interpretation.
  • Legionella urinary antigen testing.

Main Results:

  • Legionella can present as mild encephalitis/encephalopathy.
  • A characteristic finding is a reversible splenial lesion on MRI.
  • Cerebrospinal fluid (CSF) analysis may not show abnormalities.
  • Urinary antigen tests can aid in diagnosis.

Conclusions:

  • Legionella should be considered in the differential diagnosis of encephalitis/encephalopathy, particularly in patients with relevant risk factors.
  • Brain MRI and legionella urinary antigen testing are valuable diagnostic tools when CSF is normal.