Acute disseminated encephalomyelitis presenting as fever of unknown origin: case report

BMC Pediatr. 2011 Nov 10;11:103. doi: 10.1186/1471-2431-11-103.


Background: Fever of unknown origin (FUO) can be defined as a body temperature higher than 38.3°C on several occasions over more than 3 weeks, the diagnosis of which remains uncertain after 1 week of evaluation. Acute disseminated encephalomyelitis (ADEM) is an inflammatory demyelinating disease of the central nervous system with a wide range of clinical manifestations. The highest incidence of ADEM is observed during childhood and it usually occurs following a viral or bacterial infection or, more rarely, following a vaccination, or without a preceding cause.

Case presentation: Here, we describe an atypical case of ADEM that initially manifested as several weeks of FUO in a fifteen years old boy.

Conclusions: This case report suggests a new possible syndromic association between ADEM and FUO, which should be considered in the clinical examination of patients with FUO, especially in the presence of also modest neurologic or neuropsychiatric symptoms.

Publication types

  • Case Reports

MeSH terms

  • Diagnosis, Differential
  • Encephalomyelitis, Acute Disseminated / complications*
  • Encephalomyelitis, Acute Disseminated / diagnosis
  • Encephalomyelitis, Acute Disseminated / drug therapy
  • Fever of Unknown Origin / diagnosis
  • Fever of Unknown Origin / drug therapy
  • Fever of Unknown Origin / etiology*
  • Follow-Up Studies
  • Glucocorticoids / therapeutic use
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Tomography, X-Ray Computed
  • Young Adult


  • Glucocorticoids