Guison J, Groza M, Stoica O, Blaison G
Service de médecine interne et maladies infectieuses, hôpital Pasteur, hôpitaux civils de Colmar, 39, avenue de la Liberté, 68024 Colmar, France.
Service de médecine interne et maladies infectieuses, hôpital Pasteur, hôpitaux civils de Colmar, 39, avenue de la Liberté, 68024 Colmar, France.
Rev Med Interne. 2017 Apr;38(4):278-281. doi: 10.1016/j.revmed.2016.06.009. Epub 2016 Jul 20.
MRI should be performed in the presence of an acute febrile urinary retention, when septic and obstructive causes are eliminated. We report a case of post-infectious probable acute disseminated encephalomyelitis (ADEM) with a mostly spinal cord tropism of involving Campylobacter.
A 32-year-old man with no medical history was admitted for an acute febrile urinary retention. He reported severe diarrhea 3 days before. Clinical course was then complicated by a progressive tetraparesis predominating in the lower limbs. Medullar MRI showed thoracic myelitis. A five-day course of intravenous corticosteroids allowed a full recovery of both the motor and urinary symptoms. Fecal culture isolated Campylobacter sp. Final diagnosis was post-bacterial ADEM.
Clinical findings and MRI allow clinicians to suspect acute disseminated encephalomyelitis. This hypothesis implies to actively look for recent infections or vaccinations preceding the clinical presentation.
当排除感染性和梗阻性病因后，急性发热性尿潴留患者应进行磁共振成像（MRI）检查。我们报告一例感染后可能的急性播散性脑脊髓炎（ADEM）病例，该病例主要累及脊髓，病原体为弯曲杆菌。
一名无病史的32岁男性因急性发热性尿潴留入院。他自述3天前出现严重腹泻。随后临床病程因以下肢为主的进行性四肢轻瘫而复杂化。脊髓MRI显示胸段脊髓炎。为期五天的静脉注射皮质类固醇治疗使运动和泌尿系统症状完全恢复。粪便培养分离出弯曲杆菌属。最终诊断为细菌性感染后ADEM。
临床症状和MRI有助于临床医生怀疑急性播散性脑脊髓炎。这一假设意味着要积极寻找临床表现出现之前近期的感染或疫苗接种情况。
