Department of Pediatric Neurology, Dr. Sami Ulus Maternity and Children's Health and Diseases Training and Research Hospital, Ankara, Turkey.
Pediatr Neurol. 2013 Mar;48(3):236-9. doi: 10.1016/j.pediatrneurol.2012.11.004.
Acute disseminated encephalomyelitis is an acute demyelinating disorder of the central nervous system, which principally affects the brain and spinal cord. It usually follows a benign infection or vaccination in children. Although a number of infectious agents have been implicated in acute disseminated encephalomyelitis, Toxoplasma gondii infection has not been described previously in children. Acquired T. gondii infection presents with lymphadenopathy and fever and usually spontaneously resolves in immunocompetent patients. We describe a previously healthy 10-year-old boy with acute disseminated encephalomyelitis associated with acute acquired Toxoplasma gondii infection, the symptoms of which initially began with nuchal stiffness, difficulty in walking, and urinary and stool incontinence; he later had development of motor and sensory impairment in both lower extremities and classical magnetic resonance imaging lesions suggestive of the disease. The patient recovered completely after the specific therapy for acquired T. gondii infection and pulse prednisolone. Although acute acquired Toxoplasma gondii infection has not been reported previously in association with acute disseminated encephalomyelitis, clinicians should keep in mind this uncommon cause of a common disease when evaluating a patient with acute disseminated encephalomyelitis.
急性播散性脑脊髓炎是一种中枢神经系统的急性脱髓鞘疾病，主要影响大脑和脊髓。它通常发生在儿童良性感染或疫苗接种后。尽管许多病原体与急性播散性脑脊髓炎有关，但以前尚未在儿童中描述过弓形体感染。获得性弓形体感染表现为淋巴结病和发热，通常在免疫功能正常的患者中自行消退。我们描述了一例以前健康的 10 岁男孩，患有急性播散性脑脊髓炎伴急性获得性弓形体感染，其最初的症状是颈项强直、行走困难和大小便失禁；随后下肢出现运动和感觉障碍，经典磁共振成像病变提示该病。在针对获得性弓形体感染和脉冲泼尼松龙进行特异性治疗后，患者完全康复。虽然以前没有报道过急性获得性弓形体感染与急性播散性脑脊髓炎有关，但当评估急性播散性脑脊髓炎患者时，临床医生应记住这种常见疾病的不常见病因。
