Acute hemorrhagic encephalitis in pediatric patient: a case report


  • Rushikesh Gavhane Department of Pediatrics, GMCH, Aurangabad, Maharashtra, India
  • Abhishek Jain Department of Pediatrics, GMCH, Aurangabad, Maharashtra, India
  • Shilpa Pawar Department of Pediatrics, GMCH, Aurangabad, Maharashtra, India
  • Trupti Joshi Department of Pediatrics, GMCH, Aurangabad, Maharashtra, India
  • Prabha Khaire Department of Pediatrics, GMCH, Aurangabad, Maharashtra, India



ADEM, AHEM, Encephalitis, Immunoglobulins


Acute hemorrhagic encephalomyelitis (AHEM) is considered a rare presentation of acute disseminated encephalomyelitis (ADEM) and is challenging to manage. ADEM is a rare illness with an incidence of 0.2–0.4 per 100,000 children annually. Here we discuss a case report of a 3-year-old patient who presented with the clinical features of ADEM. On neuroimaging patient had a rare form of ADEM as hemorrhagic encephalitis. AHEM incidence is very low in the pediatric age group with poor prognosis. With the use of immunosuppressants and immunoglobulin, the survival of the patient was possible.


Tenembaum S, Chitnis T, Ness J, Hahn JS. Acute disseminated encephalomyelitis. Neurology. 2007;68(16):S23-36.

Leake JA, Billman GF, Nespeca MP, Duthie SE, Dory CE, Meltzer HS, Bradley JS. Pediatric acute hemorrhagic leukoencephalitis: report of a surviving patient and review. Clin Infect Dis. 2002;34(5):699-703.

Mader I, Wolff M, Niemann G, Küker W. Acute hemorrhagic encephalomyelitis (AHEM): MRI findings. Neuropediatrics. 2004;35(02):143-6.

Anlar B, Basaran C, Kose G, Guven A, Haspolat S, Yakut A, et al. Acute disseminated encephalomyelitis in children: outcome and prognosis. Neuropediatrics. 2003;34(04):194-9.

Dale RD, De Sousa C, Chong WK, Cox TC, Harding B, Neville BG. Acute disseminated encephalomyelitis, multiphasic disseminated encephalomyelitis, and multiple sclerosis in children. Brain. 2000;123(12):2407-22.

Marks WA, Bodensteiner JB, Bobele GB, Hamza M, Wilson DA. Proinflammatory Leukoencephalomyelitis: Clinical and Magnetic Resonance Imaging Findings. J Child Neurol. 1988;3(3):205-13.

Meilof JF, Hijdra A, Vermeulen M. Successful recovery after high-dose intravenous methylprednisolone in acute hemorrhagic leukoencephalitis. J Neurol. 2001;248(10):898.

Sonneville R, Klein IF, Wolff M. Update on investigation and management of post-infectious encephalitis. Curr Opinion Neurol. 2010;23(3):300-4.






Case Reports