de Lau Lonneke M L, Siepman Dorine A M, Remmers Michel J M, Terwindt Gisela M, Hintzen Rogier Q
Department of Neurology, Erasmus Medical Center, 3000 CA Rotterdam, the Netherlands.
Arch Neurol. 2010 May;67(5):623-6. doi: 10.1001/archneurol.2010.75.
To describe 2 patients presenting with severe neurological deficits and extensive lesions on brain magnetic resonance imaging after having experienced Legionella pneumonia.
Case reports.
University hospital.
Two patients who developed severe neurological symptoms, including encephalopathic signs, following Legionella infection, with widespread lesions on magnetic resonance imaging compatible with demyelination.
After extensive ancillary investigations, a diagnosis of acute disseminating encephalomyelitis was considered most likely. Steroid therapy was initiated in 1 of the patients, followed by plasmapheresis. In both patients, clinical and radiological signs gradually recovered, with only slight residual deficits.
In patients presenting with neurological symptoms after an episode of pneumonia, Legionella infection and a subsequent immune-mediated process such as acute disseminating encephalomyelitis should be considered.
描述2例在患军团菌肺炎后出现严重神经功能缺损且脑磁共振成像显示广泛病变的患者。
病例报告。
大学医院。
2例患者在感染军团菌后出现严重神经症状，包括脑病体征，磁共振成像显示广泛病变，符合脱髓鞘改变。
经过广泛的辅助检查，最可能的诊断为急性播散性脑脊髓炎。1例患者开始使用类固醇治疗，随后进行血浆置换。2例患者的临床和影像学体征均逐渐恢复，仅遗留轻微的功能缺损。
对于肺炎发作后出现神经症状的患者，应考虑军团菌感染以及随后的免疫介导过程，如急性播散性脑脊髓炎。
