Acute disseminated encephalomyelitis following pleural empyema owing to Boerhaave's syndrome

J Child Neurol. 2004 Mar;19(3):224-7.

Abstract

Acute disseminated encephalomyelitis is reported in a 14-year-old male patient associated with a pleural empyema caused by an esophageal perforation. During the hospital course, the patient experienced an episode of cardiac arrest, raising the question of hypoxic-ischemic cerebral injury, but the magnetic resonance imaging (MRI) findings and clinical course were most consistent with acute disseminated encephalomyelitis. After a course of methylprednisolone, broad-spectrum antibiotics, and bilateral chest tube placement, the patient recovered with only mild residual deficits, along with resolution of his MRI findings.

Publication types

  • Case Reports

MeSH terms

  • Adolescent
  • Anti-Bacterial Agents
  • Candidiasis / diagnosis
  • Candidiasis / drug therapy
  • Cerebral Cortex / pathology
  • Chest Tubes
  • Diagnosis, Differential
  • Drug Therapy, Combination / therapeutic use
  • Eikenella corrodens / drug effects
  • Electroencephalography
  • Empyema, Pleural / diagnosis*
  • Empyema, Pleural / drug therapy
  • Encephalomyelitis, Acute Disseminated / diagnosis*
  • Encephalomyelitis, Acute Disseminated / drug therapy
  • Esophageal Perforation / complications*
  • Esophageal Perforation / diagnosis
  • Esophageal Perforation / drug therapy
  • Follow-Up Studies
  • Foodborne Diseases / complications
  • Gram-Negative Bacterial Infections / diagnosis
  • Gram-Negative Bacterial Infections / drug therapy
  • Heart Arrest / etiology
  • Humans
  • Magnetic Resonance Imaging*
  • Male
  • Methylprednisolone / therapeutic use
  • Neurologic Examination / drug effects
  • Resuscitation
  • Streptococcal Infections / diagnosis
  • Streptococcal Infections / drug therapy
  • Streptococcus pyogenes / drug effects
  • Syndrome
  • Veillonella / drug effects

Substances

  • Anti-Bacterial Agents
  • Methylprednisolone