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Adult-onset Mild Encephalitis/Encephalopathy with a Reversible Splenial Lesion Induced by MRSA Endocarditis

Hideharu Hagiya1, Fumio Otsuka1

  • 1Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.

European Journal of Case Reports in Internal Medicine
|March 10, 2022
PubMed
Abstract

Insights

Adult-onset mild encephalitis/encephalopathy and a reversible splenial lesion (MERS) is rare. Physicians should consider MRSA endocarditis as a cause for MERS, a condition presenting with reversible splenial lesions.

Area of Science:

  • Neurology
  • Infectious Diseases
  • Radiology

Background:

  • Mild encephalitis/encephalopathy and a reversible splenial lesion (MERS) is a rare clinicoradiological syndrome.
  • Adult-onset MERS is exceptionally uncommon, with an unknown pathogenic mechanism.

Purpose of the Study:

  • To report a rare case of adult-onset MERS.
  • To highlight methicillin-resistant Staphylococcus aureus (MRSA) endocarditis as a potential cause of MERS.
  • To emphasize the importance of considering MERS in the differential diagnosis of splenial lesions.

Main Methods:

  • Case presentation of a 71-year-old man with fever and disorientation.
  • Blood culture identified MRSA; echocardiography revealed endocarditis.
  • MRI demonstrated a characteristic lesion in the splenium of the corpus callosum.

Main Results:

  • The patient was diagnosed with MERS induced by MRSA endocarditis.
  • The splenial lesion was consistent with MERS.
  • Neurological impairment in MERS is potentially reversible.

Conclusions:

  • Adult-onset MERS is rare and should be considered in the differential diagnosis of splenial lesions.
  • MRSA endocarditis is a rare but possible trigger for MERS.
  • Differential diagnoses for splenial lesions include ischemic lesions, MS, lymphoma, ADEM, and PRES.
Keywords:
BacteraemiaStaphylococcus aureuscorpus callosuminfective endocarditismild encephalitis/encephalopathy with a reversible splenial lesion

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