An unusual presentation of infective endocarditis: Transient encephalopathy with reversible lesions in corpus callosum and white matter

ABSTRACT

Clinical mild encephalitis/encephalopathy with a reversible splenial lesion (MERS) is a clinicradiologicalsyndrome, which has been reported to be associated with many conditions and the mostcommon pathogens are virus. However, bacteria are rare pathogens for MERS. We report a 20-year-oldman diagnosed with definite infective endocarditis, who presented with transient encephalopathy withreversible lesions in the entire corpus callosum and bilateral white matter on magnetic resonance imaging(MRI). The blood culture indicated a Staphylococcus aureus infection. His neurological manifestationimproved and imaging abnormalities faded after receiving a combination of intravenous immunoglobulin,methylprednisolone, and antibiotics. Clinicians should be aware of transient encephalopathy withreversible callosal lesions as a potential unusual presentation of infective endocarditis.