Postinfectious Encephalopathy in a Child following

The Campylobacter species of bacteria has become a well-known group of infectious agents. It is now recognized that Campylobacter jejuni is a leading cause of diarrheal illness, both in developing and industrialized countries around the world. While C jejuni enteritis is generally benign and self-limited, complications can arise, including bacteremia, vasculitis, arthritis, and septic abortions (1, 2) . Infection and the inflammatory response to infection can lead to neurologic complications, including meningitis, stroke, empyema, encephalopathy (3), and Guillain-Barre syndrome and its variants (4). C jejuni enteritis leading to postinfectious encephalopathy is an unusual complication. Postinfectious encephalomyelitis is an acute, inflammatory, demyelinating disease of the central nervous system (CNS) which occurs most commonly in childhood, but is occasionally seen in adults. The clinical onset is usually 5 days to 2 weeks after a nonspecific upper respiratory infection, viral illness, or vaccination, but is not specific to these events and has been reported following bacterial infections and drug and serum administrations (5). The terms acute disseminated encephalomyelitis (ADEM), acute demyelinating encephalomyelitis, and perivascular myelinoclasis are names coined to describe the pathologic features and probably refer to the same disorder (5). We will describe the magnetic resonance (MR) findings in a young child in whom acute encephalopathy developed due to immune complexmediated vascular injury largely confined to the gray matter and the immediate subcortical white matter following C jejuni enteritis. In this case, the antecedent infection was well documented and the subsequent encephalopathy was extensively studied by cultures, serum and cerebrospinal fluid (CSF) serologies, brain biopsy, and serial MR scans.