ACUTE DISSEMINATED ENCEPHALOMYELITIS FOLLOWING PONTIAC FEVER

We report the case of a 35-year-old woman who developed headache and p sychosis and gradually became comatose within 3 weeks after a flu-like infection. MRI revealed bifrontal demyelination consistent with acute disseminating encephalomyelitis (ADEM). Two different cerebrospinal f luid samples were positively tested for Legionella cincinnatiensis by direct sequencing of a PCR-amplified Legionella-specific fragment, Thi s result made it possible to interpret the initial symptoms as Pontiac fever. We think it most likely that this is a case of ADEM following the very rare situation of a systemic infection with L. cincinnatiensi s, A review of the literature on Legionella-associated encephalopathy suggests that some of these cases may also have had ADEM.