Parainfectious encephalomyeloradiculitis associated with bacterial meningitis: a case report

INTRODUCTION: Acute disseminated encephalomyelitis in adulthood occurs in most cases after a viral infection. Acute disseminated encephalomyelitis associated with bacterial meningitis, however, is quite rare. CASE PRESENTATION: An 82-year-old Japanese woman presented with a fever and somnolence. Increased neutrophil count and protein content, and decreased glucose levels in her cerebrospinal fluid initially suggested bacterial meningitis. Brain magnetic resonance imaging on admission showed bilateral symmetrical lesions in her brainstem and her cerebellum. She was diagnosed with acute disseminated encephalomyelitis following bacterial meningitis. Even though appropriate antibiotic and steroid treatment improved her symptoms, she developed transverse myelitis and lumbosacral polyradiculitis on day 9. CONCLUSIONS: Parainfectious encephalomyeloradiculitis, a variant of acute disseminated encephalomyelitis, is a unique neurological syndrome that may be caused by bacterial infection in the central nervous system.