• Jialu Xu, Feng Gao, Zhefeng Yuan, Lihua Jiang, Zhezhi Xia, and Zhengyan Zhao.
• Children's Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, China.
• Medicine (Baltimore). 2018 Jul 1; 97 (30): e11561.

RationaleMild encephalitis/encephalopathy with a reversible splenial lesion is a clinico-radiological syndrome mainly triggered by viral infection. Bacteria, like listeria monocytogenes, are relatively rare pathogens.Patient ConcernsA two and a half years old girl with a 3-day history of fever and vomiting, complicated by a sudden seizure. She was in a coma after seizure.DiagnosesListeria monocytogenes was detected in cerebrospinal fluid cultures. Serum IL-6 remarkably elevated, and hyponatremia appeared on day 2 of hospitalization. Magnetic resonance imaging of the brain performed on day 3 of hospitalization showed right subdural effusion and a lesion in the central portion of the splenium of the corpus callosum.InterventionsWe administered antimicrobial therapy, intravenous mannitol and hypertonic fluid therapy.OutcomesHer neurological symptoms improved gradually. The lesion in the splenium of the corpus callosum completely disappeared on magnetic resonance imaging on day 10 of hospitalization.LessonsWe diagnosed this case as mild encephalitis/encephalopathy with a reversible splenial lesion caused by listeria monocytogenes. The patient recovered completely clinically and on imaging, without any specific immunomodulatory treatment. It also indicated IL-6 may play a role in the forms of hyponatremia in mild encephalitis/encephalopathy with a reversible splenial lesion.

39 keywords...

hide…