Acute Hemorrhagic Encephalomyelitis Following Pneumococcal Meningitis in a 19Years Old Girl

Acute hemorrhagic encephalomyelitis (AHEM) is a rare fulminant subtype of acute disseminated encephalomyelitis (ADEM). ADEM is characterized by multifocal neurological deficit, loss of consciousness and fever. These are commonly occurred following viral or bacterial infections or vaccination in children. The focal intensities representing of inflammation and hemorrhages in MRI are so valuable for diagnosis of AHEM. Here, we present a case of AHEM following alpha-hemolytic streptococci meningitis presented with fever and loss of consciousness. She was first treated with antibiotics but owing to recurrence of loss of consciousness, she undergone serial MRIs. T1W high signal intensities in her white matter were suggestive of AHEM. The patient was treated with high-dose of methylprednisolone and IVIg and then she had gotten awake and her symptoms had revealed.