• Hiroshi Kometani, Masao Kawatani, Genrei Ohta, Shintaro Okazaki, Kazumasa Ogura, Motoko Yasutomi, Akihiko Tanizawa, and Yusei Ohshima.
• Department of Pediatrics, Faculty of Medical Sciences, University of Fukui, Fukui, Japan. Electronic address: hkometa@hotmail.co.jp.
• Brain Dev. 2014 Jun 1; 36 (6): 551-3.

AbstractThis report describes two cases of mild encephalitis/encephalopathy with reversible splenial lesion (MERS) associated with acute focal bacterial nephritis (AFBN). The patients, who presented with fever and delirious behavior, exhibited hyponatremia and markedly elevated interleukin (IL)-6 in cerebrospinal fluid (CSF) and serum. Enterococcus faecalis was detected in the urine culture. After ampicillin treatment, their consciousness improved without neurological sequelae. Moreover, a diffusion-weighted MRI abnormality, i.e., intensified signals in splenium of the corpus callosum, disappeared. MERS is a possible complication of AFBN. Elevated CSF IL-6 levels suggest that remote activation of intracerebral immune response through the immune-neuroendocrine pathway might play an important role in the pathophysiology of MERS. Copyright © 2013 The Japanese Society of Child Neurology. Published by Elsevier B.V. All rights reserved.

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