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Acute disseminated encephalomyelitis following Campylobacter jejuni gastroenteritis: Case report and review of the literature

机译:空肠弯曲菌胃肠炎后的急性播散性脑脊髓炎:病例报告及文献复习

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摘要

We describe a case of a 25-year-old male with a diagnosis of acute disseminated encephalomyelitis (ADEM) following infection with Campylobacter jejuni, which is implicated in various human pathologies regarding the central nervous system (CNS) with acute course like Guillain-Barré syndrome (GBS), Miller-Fisher syndrome (MFS), Bickerstaff's brainstem encephalitis (BEE), acute transverse myelitis (ATM) as well as ADEM. These conditions are caused by cross-reactivity between Campylobacter's epitopes and cells of the CNS that causes an immunomediated inflammatory demyelination of the CNS. In the acute phase, magnetic resonance (MR) can detect pathologic signal intensity at the CNS with areas of pathologic contrast enhancement at cortical and spinal white matter that normalize over time or can be stable. These findings can be associated with edema in parts of the CNS. The lesions typically appear at different times during the disease course and also can have a different evolution. Our purpose therefore was to describe the clinical course and MR findings of this case and perform a critical review of the literature.
机译:我们描述了一例25岁的男性,患有空肠弯曲菌感染后被诊断为急性播散性脑脊髓炎(ADEM),这与中枢神经系统(CNS)的急性发作有关,涉及各种人类病理,例如格林-巴雷氏综合症(GBS),米勒-菲舍氏综合症(MFS),比克斯塔夫脑干脑炎(BEE),急性横贯性脊髓炎(ATM)以及ADEM。这些状况是由弯曲杆菌抗原决定簇和中枢神经系统细胞之间的交叉反应引起的,该交叉反应导致中枢神经系统免疫介导的炎症性脱髓鞘作用。在急性期,磁共振(MR)可以检测中枢神经系统的病理信号强度,其皮质和脊柱白质的病理对比增强区域可以随时间恢复正常或可以保持稳定。这些发现可能与中枢神经系统部分水肿有关。病变通常在疾病过程中的不同时间出现,并且可能具有不同的演变。因此,我们的目的是描述这种情况的临床过程和MR发现,并对文献进行严格的审查。

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