TY - JOUR T1 - Amoebic encephalitis mimicking acute disseminated encephalomyelitis JF - Practical Neurology JO - Pract Neurol SP - 433 LP - 434 DO - 10.1136/practneurol-2021-002931 VL - 21 IS - 5 AU - Yuhei Otowa AU - Isamu Yamakawa AU - Nobuhiro Ogawa AU - Akihiro Kitamura AU - Hyou Kim AU - Mitsuru Sanada AU - Makoto Urushitani Y1 - 2021/10/01 UR - http://pn.bmj.com/content/21/5/433.abstract N2 - A 16-year-old Japanese girl presented with left hemiparesis and coma, following a 2-day history of headache and fever. She had been previously well and no history of a skin wound. MR scan of the brain showed a 6 cm lesion in the right frontal white matter with mass effect and slight edge enhancement (figure 1). A craniotomy was performed for external decompression and brain biopsy. The intraoperative finding was of white matter necrosis rather than tumour or abscess. An interim biopsy showed prominent neutrophil infiltration and fibrinoid necrosis in small vessels but no evidence of a specific pathogen. We suspected either a central nervous system infection or an autoimmune disease such as acute disseminated encephalomyelitis, and so started antibiotics and pulsed corticosteroids in the intensive care unit.Figure 1 MR scan of brain on admission showing a mass lesion in the right frontal lobe. The fluid-attenuated inversion recovery (FLAIR) image … ER -