Brainstem abscess and the syndrome of acute tegmental encephalitis.

A 63-year-old man developed the acute onset and rapid progression of signs of lower brainstem dysfunction accompanied by a sterile cerebrospinal fluid containing moderate pleocytosis. Autopsy examination disclosed diffuse acute bacterial inflammation of the brainstem tegmentum. The findings in 55 additional cases of brainstem bacterial infections are reviewed and discussed with respect to differential diagnosis and potential treatment.