CT and MRI findings in a pediatric case of eastern equine encephalitis

CT and MRI were performed on a pediatric patient with serology-confirmed eastern equine encephalitis (EEE). In the correct clinical setting, these findings should prompt the obtaining of appropriate serologic confirmatory tests and lead to institution of control measures to prevent spread of the disease. Evidence of both diffuse and focal disease was evident with diffuse cortical involvement as well as lesions in the basal ganglia and thalamus on T2 axial FLAIR MRI images. The diffusion weighted MRI images (DWI) showed gyriform regions with restricted diffusion in bifrontal lobes in addition to Apparent Diffusion Coefficient (ADC) MRI images that showed signal drop out in the same location, suggesting meningoencephalitis. Our case highlights the importance of inclusion of eastern equine encephalitis in the pediatric population in the Onondaga County region. Clinical correlation and radiographic findings should be implemented together in early identification of eastern equine encephalitis in the pediatric population as mortality from this disease is extremely high. Confirmed infection with eastern equine encephalitis virus warrants immediate notification of public health departments so that appropriate control measures can be implemented.