Adult-Onset Acute Disseminated Encephalomyelitis with Epstein-Barr Virus Infection
We present the case of a 22-year-old man who was diagnosed with tonsillitis and treated with antibiotics. Although the symptoms subsided, 1 week later, he presented with weakness in the lower limbs and was hospitalized. The weakness in the lower limbs worsened; he developed difficulty speaking and w...
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| Format: | Article |
| Language: | English |
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Wiley
2022-01-01
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| Series: | Case Reports in Radiology |
| Online Access: | http://dx.doi.org/10.1155/2022/6149501 |
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| author | Emika Murasawa Masazumi Matsuda Koichi Ishiyama Tetsugaku Shinozaki Toshiki Murata Manabu Hashimoto |
| author_facet | Emika Murasawa Masazumi Matsuda Koichi Ishiyama Tetsugaku Shinozaki Toshiki Murata Manabu Hashimoto |
| author_sort | Emika Murasawa |
| collection | DOAJ |
| description | We present the case of a 22-year-old man who was diagnosed with tonsillitis and treated with antibiotics. Although the symptoms subsided, 1 week later, he presented with weakness in the lower limbs and was hospitalized. The weakness in the lower limbs worsened; he developed difficulty speaking and was transferred to our hospital. Laboratory tests showed a white blood cell count of 10,600/μL (24% atypical lymphocytes). Positive results were obtained for immunoglobulin M (IgM) antibody against Epstein-Barr virus (EBV) viral capsid antigen. EBV-deoxyribonucleic acid quantification in blood yielded positive results. Magnetic resonance imaging (MRI) revealed a hyperintensity in the spinal cord at the Th11 level of the lower spine on T2-weighted imaging (T2WI). In addition, T2WI and fluid-attenuated inversion recovery imaging showed hyperintense lesions on the right cerebral peduncle, bilateral thalami, posterior leg of the left internal capsule, and right corona radiata. We diagnosed acute disseminated encephalomyelitis (ADEM) with EBV and initiated steroid pulse therapy. Symptoms, along with the lesions seen on MRI, subsequently ameliorated. This case suggests that ADEM can be difficult to diagnose, but careful diagnosis is crucial since appropriate treatment is necessary to improve the symptoms. |
| format | Article |
| id | doaj-art-e45e1d0d10c841f38dc174825bbab63e |
| institution | Kabale University |
| issn | 2090-6870 |
| language | English |
| publishDate | 2022-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Radiology |
| spelling | doaj-art-e45e1d0d10c841f38dc174825bbab63e2025-08-20T03:26:26ZengWileyCase Reports in Radiology2090-68702022-01-01202210.1155/2022/6149501Adult-Onset Acute Disseminated Encephalomyelitis with Epstein-Barr Virus InfectionEmika Murasawa0Masazumi Matsuda1Koichi Ishiyama2Tetsugaku Shinozaki3Toshiki Murata4Manabu Hashimoto5Department of RadiologyDepartment of RadiologyDepartment of RadiologyDepartment of RadiologyDepartment of RadiologyDepartment of RadiologyWe present the case of a 22-year-old man who was diagnosed with tonsillitis and treated with antibiotics. Although the symptoms subsided, 1 week later, he presented with weakness in the lower limbs and was hospitalized. The weakness in the lower limbs worsened; he developed difficulty speaking and was transferred to our hospital. Laboratory tests showed a white blood cell count of 10,600/μL (24% atypical lymphocytes). Positive results were obtained for immunoglobulin M (IgM) antibody against Epstein-Barr virus (EBV) viral capsid antigen. EBV-deoxyribonucleic acid quantification in blood yielded positive results. Magnetic resonance imaging (MRI) revealed a hyperintensity in the spinal cord at the Th11 level of the lower spine on T2-weighted imaging (T2WI). In addition, T2WI and fluid-attenuated inversion recovery imaging showed hyperintense lesions on the right cerebral peduncle, bilateral thalami, posterior leg of the left internal capsule, and right corona radiata. We diagnosed acute disseminated encephalomyelitis (ADEM) with EBV and initiated steroid pulse therapy. Symptoms, along with the lesions seen on MRI, subsequently ameliorated. This case suggests that ADEM can be difficult to diagnose, but careful diagnosis is crucial since appropriate treatment is necessary to improve the symptoms.http://dx.doi.org/10.1155/2022/6149501 |
| spellingShingle | Emika Murasawa Masazumi Matsuda Koichi Ishiyama Tetsugaku Shinozaki Toshiki Murata Manabu Hashimoto Adult-Onset Acute Disseminated Encephalomyelitis with Epstein-Barr Virus Infection Case Reports in Radiology |
| title | Adult-Onset Acute Disseminated Encephalomyelitis with Epstein-Barr Virus Infection |
| title_full | Adult-Onset Acute Disseminated Encephalomyelitis with Epstein-Barr Virus Infection |
| title_fullStr | Adult-Onset Acute Disseminated Encephalomyelitis with Epstein-Barr Virus Infection |
| title_full_unstemmed | Adult-Onset Acute Disseminated Encephalomyelitis with Epstein-Barr Virus Infection |
| title_short | Adult-Onset Acute Disseminated Encephalomyelitis with Epstein-Barr Virus Infection |
| title_sort | adult onset acute disseminated encephalomyelitis with epstein barr virus infection |
| url | http://dx.doi.org/10.1155/2022/6149501 |
| work_keys_str_mv | AT emikamurasawa adultonsetacutedisseminatedencephalomyelitiswithepsteinbarrvirusinfection AT masazumimatsuda adultonsetacutedisseminatedencephalomyelitiswithepsteinbarrvirusinfection AT koichiishiyama adultonsetacutedisseminatedencephalomyelitiswithepsteinbarrvirusinfection AT tetsugakushinozaki adultonsetacutedisseminatedencephalomyelitiswithepsteinbarrvirusinfection AT toshikimurata adultonsetacutedisseminatedencephalomyelitiswithepsteinbarrvirusinfection AT manabuhashimoto adultonsetacutedisseminatedencephalomyelitiswithepsteinbarrvirusinfection |