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OP-130 During treatment with methylprednisolone in a sixteen-year-old male patient diagnosed with multiple sclerosis, staphylococcus aureus was isolated in the cerebrospinal fluid and brain abscess development
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  1. Sevinç Mertoğlu,
  2. Merve Çakmak,
  3. İhsan Kafadar
  1. Istanbul Başakşehir Çam and Sakura City Hospital, Turkey

Abstract

Aim To present a rare complication that develops during treatment in pediatric patients with multiple sclerosis as an original case in the light of the literature. Original case.

Material and Method Multiple Sclerosis (MS) is an autoimmune central nervous system disease characterized by inflammation, demyelination and axon damage. Myelin sheaths, oligodendrocytes and, to a lesser extent, the axon and nerve cell itself are damaged. The disease often occurs in young adults. The main feature of the relapsing-remitting form of Multiple Sclerosis is that it progresses with attacks. An attack is defined as the worsening period of MS resulting from inflammatory and demyelinating causes, in which new findings appear or existing findings increase, and new neurological findings are detected lasting at least 24 hours. Methylprednisolone is frequently used in the treatment of attacks. [1] A 16-year-old male patient, who was diagnosed with MS six months ago and treated with methylprednisolone, applied to us again due to blurred vision, dizziness and weakness in the feet. The patient was evaluated as a second attack and pulse methylprednisolone treatment was started. It was aimed to present the treatment and clinical course of the patient diagnosed with MS, who developed cerebral abscess during follow-up, as an original case, in the light of the literature (MRI image is shown in figure 1). Additionally, Staphylococcus aureus was isolated in the patient‘s cerebrospinal fluid.

Results Our patient‘s clinic started with meningitis, but he had no seizures. Staphylococcus aureus was isolated in CSF. There was no growth in blood culture. Clinical and radiological improvement was observed after 6 weeks of intravenous meropenem and vancomycin treatment without surgical drainage of the abscess lesion.

Conclusions It was concluded that pediatric patients with multiple sclerosis should be monitored very carefully for the development of complications during treatment.

  • Multiple sclerosis
  • methylprednisolone
  • cerebral abscess
  • Staphylococcus aureus

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