Case Notes
History
11 month old male with recent gastroenteritis treated with multiple antibiotics. Fever persisted along with adenoviral lymphadenitis, increasing irritability and depressed level of consciousness. An initial head MR was obtained. Over one month developed status epilepticus & HLH (hemophagocytic lymphohistiocytosis); a second MR was obtained 3 weeks later.Exam
MR T1-w post contrast
Prior Study
MR flair1. There are minimal changes of leptomeningeal reaction or leptomeningeal infection (possibly viral). The patient has been treated with antibiotics making CSF cultures negative. Differential includes immune overshoot response to the documented GI adenoviral infections (cytokine storm/SIRS) versus actual infectious leptomeningitis.