[Acute disseminated encephalomyelitis during the acute phase of meningitis caused by Streptococcus pneumoniae: a case report.]

Abstract

Objetives: To describe a pediatric patient who developed acute disseminated encephalomyelitis (ADEM) during the acute phase of meningitis caused by Streptococcus pneumoniae, a previously unreported association.

Case report: A previously healthy 3-year-old girl presented with fever and altered consciousness. She was diagnosed with bacterial meningoencephalitis and required mechanical ventilation. S. pneumoniae was isolated from blood and cerebrospinal fluid cultures. Despite clinical improvement after antibiotic therapy, persistent neurological deficits were observed. Brain MRI revealed lesions consistent with ADEM. She received corticosteroids and intravenous immunoglobulin with favorable clinical response and was discharged with outpatient follow-up and rehabilitation.

Conclusion: This case highlights the need to consider ADEM as a differential diagnosis in children with persistent neurological symptoms during or after bacterial infections of the central nervous system. Early recognition and treatment can significantly improve outcomes.