Central European Journal of Medicine * E-mail: bwyoon@snu.ac.kr Vancomycin-resistant Enterococcus faecium-associated encephalitis and concurrent cerebellitis Received 15 November 2010; Accepted 27 April 2011 Abstract: Enterococci are uncommon etiologic agents of central nervous system infections. We describe a case of nosocomial encephalitis and concurrent cerebellitis associated with Enterococcus faecium in a man, with extranodal natural killer/T-cell lymphoma, nasal type, who underwent high-dose chemotherapy and autologous peripheral blood stem cell transplantation. Brain magnetic resonance images showed lesions in the bihemispheral cerebellar cortex with swelling and several small lesions in both cerebral hemispheres. The blood and cerebrospinal luid cultures were positive for vancomycin-resistant E. faecium. Vancomycin-resistant E. faecium can cause encephalitis and concurrent cerebellitis in an immunocompromised patient who underwent autologous peripheral blood stem cell transplantation. © Versita Sp. z o.o. Keywords: Cerebellitis • Encephalitis • Enterococcus faecium • Vancomycin • Magnetic resonance imaging • Peripheral blood stem cell transplantation • Extranodal NK-T-cell lymphoma. 1 Department of Neurology, Eulji General Hospital, 280-1 Hagye 1-dong, Nowon-gu, Seoul, Republic of Korea 2 Cancer Research Institute, Seoul National University, Seoul, Republic of Korea 3 Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea 4 Clinical Research Institute, Seoul National University Hospital, 28 Yeongeon-dong, Jongno-gu, Seoul 110-744, Republic of Korea 5 Department of Neurology, Seoul National University College of Medicine, Seoul, Republic of Korea 6 Clinical Research Center for Stroke, Seoul National University Hospital, 28 Yeongeon-dong, Jongno-gu, Seoul 110-744, Republic of Korea Kyusik Kang 1 , Sung-Soo Yoon 2,3,4 , Byung-Woo Yoon 5,6* Case Report 1. Introduction Encephalitis is an acute inlammation of the brain parenchyma and presents as fever, headache, seizures, and an alteration in consciousness [1,2]. Infectious causes of acute encephalitis are myriad [1-8]. However, a speciic etiology is identiied in less than one-third of cases, even if extensive laboratory testing is performed [2]. Encephalitis is most commonly caused by viruses such as herpes simplex virus, cytomegalovirus, varicella zoster virus, Epstein–Barr virus, enteroviruses, and lymphocytic choriomeningitis virus [1,2,8]. Other microorganisms that can cause encephalitis include protozoa, such as Toxoplasma gondii, and bacteria, such as Mycoplasma pneumoniae, Haemophilus inluenzae, Neisseria meningitides, and groups A and B streptococci [1-3,8]. Syphilis, bartonellosis, borreliosis, brucellosis, leptospirosis, tuberculosis, and listeriosis are other Cent. Eur. J. Med. • 6(4) • 2011 • 470-474 DOI: 10.2478/s11536-011-0041-1 470 Unauthenticated Download Date | 6/1/16 8:36 AM