[Acute disseminated encephalomyelitis presenting as an acute urinary febrile retention]

Abstract

Introduction: MRI should be performed in the presence of an acute febrile urinary retention, when septic and obstructive causes are eliminated. We report a case of post-infectious probable acute disseminated encephalomyelitis (ADEM) with a mostly spinal cord tropism of involving Campylobacter.

Case report: A 32-year-old man with no medical history was admitted for an acute febrile urinary retention. He reported severe diarrhea 3 days before. Clinical course was then complicated by a progressive tetraparesis predominating in the lower limbs. Medullar MRI showed thoracic myelitis. A five-day course of intravenous corticosteroids allowed a full recovery of both the motor and urinary symptoms. Fecal culture isolated Campylobacter sp. Final diagnosis was post-bacterial ADEM.

Conclusion: Clinical findings and MRI allow clinicians to suspect acute disseminated encephalomyelitis. This hypothesis implies to actively look for recent infections or vaccinations preceding the clinical presentation.

Keywords: Acute disseminated encephalomyelitis; Anti-MOG antibodies; Anticorps anti-MOG; Campylobacter; Encéphalomyélite aiguë disséminée; Febrile urinary retention; Immune-mediated disease; Pathologie immuno-médiée; Rétention aiguë d’urines; Tetraparesis; Tétraparésie.