Measles-induced Acute Disseminated Encephalomyelitis in a Non-vaccinated Patient

Deeba Ali; Arnaud Detroz; Yilmaz Gorur; Lionel Bosquee; Noel Lorenzo Villalba; Benoît Cardos

doi:10.12890/2020_001332

Measles-induced Acute Disseminated Encephalomyelitis in a Non-vaccinated Patient

Eur J Case Rep Intern Med. 2020 Apr 6;7(6):001332. doi: 10.12890/2020_001332. eCollection 2020.

Authors

Deeba Ali¹, Arnaud Detroz¹, Yilmaz Gorur², Lionel Bosquee³, Noel Lorenzo Villalba⁴, Benoît Cardos⁵

Affiliations

¹ University of Liège, CHU Liège, Liège, Belgium.
² Service de Radiologie, Clinique André Renard, Herstal, Belgium.
³ Service de Pneumologie, Clinique André Renard, Herstal, Belgium.
⁴ Service de Médecine Interne, Diabète et Maladies Métaboliques, Hôpitaux Universitaires de Strasbourg, Strasbourg, France.
⁵ Service des Urgences, Clinique André Renard, Herstal, Belgium.

Abstract

We reported a case of measles-induced acute disseminated encephalomyelitis (ADEM) in a 40-year-old immunocompetent adult. The patient presented a week after the development of respiratory symptoms and a cutaneous rash, and was admitted to hospital for altered mental status. Blood tests showed hyperleukocytosis, thrombopenia and cytolysis. A lumbar puncture was consistent with acute meningitis and the patient was initially treated with antiviral and wide broad-spectrum antibiotics. Serology and PCR for measles came back positive.

Learning points: Acute disseminated encephalomyelitis (ADEM) associated with measles infection is not uncommon.Clinical suspicion must be based on the presence of measles infection or recent vaccination.A normal CT scan does not rule out the disease but magnetic resonance imaging (MRI) is not required to confirm the diagnosis.

Keywords: Measles; acute disseminated encephalomyelitis; magnetic resonance imaging.