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BMC Infectious Diseases

Open Access

Acute hemorrhagic encephalopathy - diagnostic challenges in a pediatric case

  • Anca Cristina Drăgănescu1Email author,
  • Monica Luminos1, 2,
  • Magda Vasile1,
  • Anuța Bilaşco1,
  • Gheorghiță Jugulete1, 2,
  • Angelica Vişan1, 2,
  • Camelia Kouris1,
  • Cristina Negulescu1,
  • Cristina Popescu1,
  • Mădălina Maria Merişescu1, 2,
  • Diana Slavu1,
  • Cornelia Dogaru1,
  • Sabina Șchiopu1 and
  • Osman Endis1
BMC Infectious Diseases201313(Suppl 1):P101

Published: 16 December 2013


Acute hemorrhagic encephalomyelitis (AHEM) is considered a rare form of Acute disseminated encephalomyelitis (ADEM), due to acute cerebral vasculitis. The symptomatology consists in similar neurological findings, (meningismus, headache, seizures, multifocal neurologic signs, asymmetrical neurological deficits and coma) with rapid onset of encephalopathy and biphasic evolution. Although previous respiratory disease was registered days before this condition, establishing etiology is quite a challenge, viruses being incriminated.

Case report

This report shows 10 months-old patient who presented with fever, seizures, multifocal neurological signs, with negative serological findings and initial favorable outcome, who developed severe neurological worsening after 3 weeks of treatment.

First magnetic resonance image (MRI) showed multifocal hyper-intense lesions affecting the CNS white matter. After 3 weeks from the initial symptoms, he had recurrence of his symptoms in association with rapidly progressive refractory status epilepticus and the second MRI showed micro-hemorrhagic lesions.

Aggressive therapeutic management was required in order to avoid the predictable fatal outcome.

Authors’ Affiliations

National Institute for Infectious Diseases “Prof. Dr. Matei Balş”, Bucharest, Romania
Carol Davila University of Medicine and Pharmacy, Bucharest, Romania


© Drăgănescu et al; licensee BioMed Central Ltd. 2013

This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.