The association of Campylobacter infection and Guillain-Barré syndrome is well recognised. We report a case of acute disseminated encephalomyelitis (ADEM) temporally associated with Campylobacter gastroenteritis in a previously fit man. A MedLine search using the keywords “ADEM”, “demyelination”, and “campylobacter” revealed no previous reports of ADEM associated with Campylobacter infection in isolation.

A 24 year old man presented to his general practitioner with a 4 day history of non-bloody diarrhoea associated with fevers and sweats. His past medical history was unremarkable. He drank 6 units of alcohol per week and smoked only occasionally. His general practitioner prescribed loperamide for symptomatic relief. Campylobacter species was later isolated from stool samples. By day 5 of his illness, his diarrhoea had settled and he had become constipated. However, he remained febrile and developed nausea and vomiting. His general practitioner prescribed erythromycin but he tolerated only two doses because of nausea.

Fourteen days into the illness he was admitted to hospital complaining of headache, fever, and sweats. Examination revealed a temperature of 38.4°C, pulse of 65 beats/min and normal blood pressure. Rectal examination revealed hard stool. There were no focal neurological signs. His haemoglobin was15.3 g/dl, leukocyte count was 13.3×10⁹/l (87.1% neutrophils) and C-reactive protein was 12.8 mg/l. Two days after admission (day 16 of illness), his family reported a change in his personality and he complained of slurring of speech, intermittent diplopia, and difficulty in walking. Examination …