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DIAGNOSTIC CHALLENGES IN A NINE-YEAR-OLD BOY WITH ADEM AND LONGITUDINAL EXTENSIVE TRANSVERSE MYELITIS

EMİNE AKKUZU, MUTLU UYSAL YAZICI, EBRU AZAPAĞASI, TUĞBA HİRFANOĞLU, BETÜL DERİNKUYU, HASAN TEZER

Çocuk Acil ve Yoğun Bakım Dergisi - 2024;11(2):137-140

Gazi University Hospital Department of Pediatrics, Division of Critical Care Medicine, Ankara, Turkey

 

Acute disseminated encephalomyelitis (ADEM), or postinfectious encephalomyelitis, is a demyelinating central nervous system disease that typically presents with multifocal neurologic symptoms and encephalopathy. Numerous pathogens have been associated with ADEM, and the implicated viruses include coronavirus, coxsackie, cytomegalovirus, Epstein-Barr, herpes simplex, hepatitis A, HIV, influenza, measles, rubella, varicella zoster, and adenovirus. Although severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) infection has been associated with ADEM, the incidence is quite low. We present the case of a 9-year-old boy with ADEM plus longitudinal extensive myelitis who had a SARS-CoV-2 infection history and acute adenovirus infection. We evaluated the diagnosis and treatment challenges. Although our patient had severe neurological respiratory failure requiring intubation and tetraplegic flaccid paralysis, he had a total recovery before hospital discharge.