Abstract
We report a 20-year-old man who presented with temporary encephalopathy. Serial brain MRI revealed an isolated and transient splenial lesion of the corpus callosum (SCC). He was subsequently diagnosed with septic metastasis of Staphylococcus aureus (S. aureus) involving both lungs and multiple joints; however, there was no indication of S. aureus involvement of the meninges or brain parenchyma in CSF and MRI studies. Within 24 h of presentation, the serum sodium concentration and effective osmolality changed by approximately 10 mmol/L and 25 mOsm/kg H(2)O, respectively. On the basis of the MRI findings, the changes in electrolyte concentration, and a review of relevant literature, an isolated and transient SCC in this case might be related to osmotic demyelination caused by fluid imbalance rather than direct invasion of S. aureus.
MeSH terms
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Adult
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Anti-Bacterial Agents / therapeutic use
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Arthritis, Infectious / complications
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Arthritis, Infectious / diagnostic imaging
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Arthritis, Infectious / microbiology
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Brain Diseases, Metabolic / microbiology*
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Brain Diseases, Metabolic / physiopathology
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Corpus Callosum / metabolism
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Corpus Callosum / pathology
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Corpus Callosum / physiopathology*
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Humans
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Joints / microbiology
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Joints / pathology
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Lung / diagnostic imaging
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Lung / microbiology
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Lung / pathology
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Magnetic Resonance Imaging
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Male
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Nerve Fibers, Myelinated / metabolism
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Nerve Fibers, Myelinated / pathology
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Osmolar Concentration
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Pneumonia, Bacterial / complications
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Pneumonia, Bacterial / diagnostic imaging
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Pneumonia, Bacterial / microbiology
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Sepsis / complications*
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Sepsis / physiopathology
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Staphylococcal Infections / complications*
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Staphylococcal Infections / drug therapy
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Staphylococcal Infections / physiopathology
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Staphylococcus aureus / physiology
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Tomography, X-Ray Computed
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Treatment Outcome
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Water-Electrolyte Balance / physiology