Acute disseminated encephalomyelitis following Pontiac fever

Eur Neurol. 1998 Oct;40(3):169-72. doi: 10.1159/000007975.


We report the case of a 35-year-old woman who developed headache and psychosis and gradually became comatose within 3 weeks after a flu-like infection. MRI revealed bifrontal demyelination consistent with acute disseminating encephalomyelitis (ADEM). Two different cerebrospinal fluid samples were positively tested for Legionella cincinnatiensis by direct sequencing of a PCR-amplified Legionella-specific fragment. This result made it possible to interpret the initial symptoms as Pontiac fever. We think it most likely that this is a case of ADEM following the very rare situation of a systemic infection with L. cincinnatiensis. A review of the literature on Legionella-associated encephalopathy suggests that some of these cases may also have had ADEM.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Electroencephalography
  • Encephalomyelitis, Acute Disseminated / diagnosis
  • Encephalomyelitis, Acute Disseminated / microbiology*
  • Evoked Potentials, Somatosensory
  • Female
  • Fever / microbiology*
  • Gram-Negative Bacterial Infections* / cerebrospinal fluid
  • Gram-Negative Bacterial Infections* / microbiology
  • Humans
  • Legionellosis* / cerebrospinal fluid
  • Legionellosis* / microbiology
  • Magnetic Resonance Imaging
  • Pons / microbiology
  • Pons / pathology*