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

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.