Measles encephalitis the return: mild encephalitis with reversible splenial lesion

A 20-year-old man, without a past medical history, was admitted for febrile coma (Glasgow coma scale score 9, temperature 39 8C). A maculopapular rash was observed on the face, trunk, arms, and proximal portion of the legs. A cerebral computed tomography (CT) scan was normal. Lumbar puncture showed 16 10 leukocytes/l, 20 10 erythrocytes/l, a cerebrospinal fluid (CSF) protein level of 0.7 g/l, and CSF glucose of 4 mmol/l (glycemia: 5.1 mmol/l). A measles-specific PCR was positive on salivary, urinary, and nasal samples. Specific PCR and culture of the CSF were all negative, including for measles. Diffusion-weighted magnetic resonance imaging (MRI) showed hyperintensity of the splenium of the corpus callosum (Figure 1). Complete recovery was observed after 1 week, and the control imaging by diffusion-weighted MRI was normal (Figure 2). Mild encephalitis with reversible splenial lesion (MERS) is an aspecific cerebral lesion visible on MRI. The most common causes are infectious agents, drugs, and hydroelectric disorders.