Loading...
Publication
Encefalomielite aguda disseminada por Mycoplasma pneumoniae
| Name: | Description: | Size: | Format: | |
|---|---|---|---|---|
| 156.92 KB | Adobe PDF |
Authors
Advisor(s)
Abstract(s)
RESUMO
Introdução: A encefalomielite aguda disseminada (ADEM) é
uma doença inflamatória desmielinizante do sistema nervoso central, mediada imunologicamente, que atinge predominantemente
a substância branca cerebral e medula espinal. Ocorre frequentemente após um quadro infecioso ou imunizações. O diagnóstico
infere-se pelo quadro clínico de alterações do nível da consciência
e do comportamento, sinais neurológicos multifocais e pelos achados típicos da ressonância magnética (RM). O tratamento de eleição são os corticoides e o prognóstico é, geralmente, favorável.
Caso clínico: Este caso clínico refere-se a uma criança, com cinco anos de idade, internada por um quadro sugestivo de meningite de provável etiologia vírica, precedida por uma infeção das vias aéreas superiores umas semanas antes. No 2º dia de internamento, iniciou alterações do comportamento e apresentava sinais de envolvimento da via piramidal. A RM do neuroeixo revelou múltiplas lesões sugestivas de desmielinização com atingimento cerebral e medular, compatíveis com ADEM.
Os exames serológicos foram sugestivos de infeção recente por
Mycoplasma pneumoniae. Realizou tratamento com corticóides
com evolução clínica favorável.
Conclusão: Pretende-se com este caso alertar para uma
entidade clínico-imagiológica de diagnóstico crescente e salientar a importância das manifestações extrapulmonares do Mycoplasma pneumoniae em idade pediátrica.
ABSTRACT Introduction: Acute Disseminated Encephalomyelitis (ADEM) is an immune-mediated inflammatory white matter demyelinating disease of the Central Nervous System involving the brain and spinal cord, often following, previous infections or immunizations. The diagnosis is infered by the clinical features of altered mental status, behavioral changes and multifocal neurological signs in association with typical findings on magnetic resonance imaging (MRI). Steroids are the first choice for treatment and prognosis is generally favorable. Case report: The authors report a five-year old boy admitted with a clinical picture suggestive of viral meningitis, following an upper respiratory tract infection a couple of weeks previously. On the second day of admission, he developed behavioral changes, with neurological signs of pyramidal tract involvement. MRI showed multiple lesions, of white matter demyelination widespread to the brain and spinal cord, compatible with ADEM. Serological testing suggested recent Mycoplasma pneumoniae infection. He responded to steroids with favorable clinical outcome. Conclusion: The aim of this report’s to illustrate a clinical-imagiological entity, highlightening the importance of Mycoplasma pneumoniae involving extrapulmonary manifestations in childhood.
ABSTRACT Introduction: Acute Disseminated Encephalomyelitis (ADEM) is an immune-mediated inflammatory white matter demyelinating disease of the Central Nervous System involving the brain and spinal cord, often following, previous infections or immunizations. The diagnosis is infered by the clinical features of altered mental status, behavioral changes and multifocal neurological signs in association with typical findings on magnetic resonance imaging (MRI). Steroids are the first choice for treatment and prognosis is generally favorable. Case report: The authors report a five-year old boy admitted with a clinical picture suggestive of viral meningitis, following an upper respiratory tract infection a couple of weeks previously. On the second day of admission, he developed behavioral changes, with neurological signs of pyramidal tract involvement. MRI showed multiple lesions, of white matter demyelination widespread to the brain and spinal cord, compatible with ADEM. Serological testing suggested recent Mycoplasma pneumoniae infection. He responded to steroids with favorable clinical outcome. Conclusion: The aim of this report’s to illustrate a clinical-imagiological entity, highlightening the importance of Mycoplasma pneumoniae involving extrapulmonary manifestations in childhood.
Description
Keywords
Alteração do comportamento corticoides encefalomielite aguda disseminada Mycoplasma pneumoniae ressonância magnética Acute disseminated encephalomyelitis, behavioural changes magnetic resonance imaging Mycoplasma pneumoniae steroids
Citation
Nascer e Crescer 2013; 22(4): 248-251