Spieker S, Petersen D, Rolfs A, Fehrenbach F, Kuntz R, Seuffer R H, Fetter M, Dichgans J
Department of Neurology,University of Tübingen, Germany.
Eur Neurol. 1998 Oct;40(3):169-72. doi: 10.1159/000007975.
We report the case of a 35-year-old woman who developed headache and psychosis and gradually became comatose within 3 weeks after a flu-like infection. MRI revealed bifrontal demyelination consistent with acute disseminating encephalomyelitis (ADEM). Two different cerebrospinal fluid samples were positively tested for Legionella cincinnatiensis by direct sequencing of a PCR-amplified Legionella-specific fragment. This result made it possible to interpret the initial symptoms as Pontiac fever. We think it most likely that this is a case of ADEM following the very rare situation of a systemic infection with L. cincinnatiensis. A review of the literature on Legionella-associated encephalopathy suggests that some of these cases may also have had ADEM.
我们报告了一例35岁女性病例，该患者在流感样感染后3周内出现头痛和精神症状，并逐渐昏迷。磁共振成像（MRI）显示双侧额叶脱髓鞘，符合急性播散性脑脊髓炎（ADEM）。通过对PCR扩增的嗜肺军团菌特异性片段进行直接测序，在两份不同的脑脊液样本中均检测到辛辛那提嗜肺军团菌呈阳性。这一结果使得最初的症状可以被解释为庞蒂亚克热。我们认为这很可能是一例在非常罕见地感染辛辛那提嗜肺军团菌后发生的ADEM病例。对与军团菌相关的脑病的文献综述表明，其中一些病例可能也患有ADEM。
