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A Case of Acute Disseminated Encephalomyelitis in Adults: Unravelling the Influenza B and Leptospirosis Co-infection
Correspondence Address :
Dr. Sai Mounika Adapa,
Resident, Department of General Medicine, D.Y. Patil Medical College, Hospital and Research Centre, Pimpri, Pune-411018, Maharastra, India.
E-mail: mounika0adapa@gmail.com
Acute Disseminated Encephalomyelitis (ADEM) is a neurological disorder characterised by demyelination, where the immune system targets the Central Nervous System (CNS). This condition typically develops rapidly, with neurological symptoms appearing within days to weeks following viral infections or immunisations. Before the onset of neurological manifestations, patients often experience systemic symptoms such as fever, headache, malaise, and myalgias. The transition from the febrile phase of illness to neurological symptoms generally occurs with a latency period of 7 to 14 days. ADEM is commonly referred to as “post-infectious,” “para-infectious,” “post-exanthematous,” or “post-vaccinal” encephalomyelitis. Recognised as a potential cause of permanent neurological disability, ADEM frequently affects individuals early in life, underscoring the significance of understanding this disease entity, particularly in the context of routine immunisation practices. Herein, the authors present the case of a 28-year-old female, who presented with quadriparesis in a drowsy state following a febrile illness. Upon further evaluation, she was diagnosed with a co-infection of Influenza B and leptospirosis, confirmed by positive serological tests. Magnetic Resonance Imaging (MRI) of the brain revealed hyperintensities suggestive of ADEM in multiple areas of the brainstem and thalamus, while Cerebrospinal Fluid (CSF) examination showed an albumin-cytological dissociative picture, further supporting the diagnosis. Treatment comprised a pulse steroid regimen followed by oral steroid tapering. Subsequently, the patient demonstrated clinical improvement over the course of a week, with progressive enhancements observed during follow-up assessments. The present case highlights the importance of prompt recognition and management of ADEM, emphasising the role of corticosteroid therapy in achieving favourable patient outcomes.
Immunisation, Infection, Neurological, Quadriparesis, Steroids
DOI: 10.7860/JCDR/2024/70148.19497
Date of Submission: Feb 15, 2024
Date of Peer Review: Mar 21, 2024
Date of Acceptance: Apr 17, 2024
Date of Publishing: Jun 01, 2024
AUTHOR DECLARATION:
• Financial or Other Competing Interests: None
• Was informed consent obtained from the subjects involved in the study? Yes
• For any images presented appropriate consent has been obtained from the subjects. Yes
PLAGIARISM CHECKING METHODS:
• Plagiarism X-checker: Feb 16, 2024
• Manual Googling: Mar 23, 2024
• iThenticate Software: Apr 15, 2024 (7%)
ETYMOLOGY: Author Origin
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