Post-infectious transverse myelitis in an older adult: A rare complication of Klebsiella bacteremia

2018 ◽  
Vol 18 (7) ◽  
pp. 1135-1136
Author(s):  
Jasmine S Lim ◽  
S Navya Putta ◽  
Surinder Pada ◽  
J En Lee
Keyword(s):  
Older Adult ◽  
Rare Complication ◽  
Transverse Myelitis ◽  
Post Infectious

scholarly journals Predictors of outcome in a large retrospective cohort of patients with transverse myelitis

2017 ◽  
Vol 24 (13) ◽  
pp. 1743-1752 ◽  
Author(s):  
Matteo Gastaldi ◽  
Enrico Marchioni ◽  
Paola Banfi ◽  
Valeria Mariani ◽  
Laura Di Lodovico ◽  
...  
Keyword(s):  
Nervous System ◽  
Connective Tissue ◽  
Autoimmune Diseases ◽  
Inflammatory Diseases ◽  
Univariate Analysis ◽  
Transverse Myelitis ◽  
Inflammatory Disorder ◽  
Prognostic Assessment ◽  
Lumbar Mri ◽  
Post Infectious

Background: Transverse myelitis (TM) is an inflammatory disorder that can be idiopathic or associated with central nervous system autoimmune/dysimmune inflammatory diseases, connective tissue autoimmune diseases, or post-infectious neurological syndromes. Prognosis of initial TM presentations is uncertain. Objective: To identify outcome predictors in TM. Methods: Retrospective study on isolated TM at onset. Scores ⩾3 on the modified Rankin scale (mRS) marked high disability. Results: A total of 159 patients were identified. TM was classified as follows: idiopathic (I-TM, n = 53), post-infectious (PI-TM, n = 48), associated with multiple sclerosis (MS-TM, n = 51), or neuromyelitis optica spectrum disorders/connective tissue autoimmune diseases/neurosarcoidosis ( n = 7). At follow-up (median, 55 months; interquartile range, 32–80), 42 patients were severely disabled, and patients with I-TM or PI-TM showed the worst outcomes. Predictors of disability were infectious antecedents, sphincter and pyramidal symptoms, high mRS scores, blood–cerebrospinal fluid barrier damage, lumbar magnetic resonance imaging (MRI) lesions on univariate analysis, and older age (odds ratio (OR), 1.1; 95% confidence interval (CI), 1.0–1.1), overt/subclinical involvement of the peripheral nervous system (PNS) (OR, 9.4; 95% CI, 2.2–41.0), complete TM (OR, 10.8; 95% CI, 3.4–34.5) on multivariate analysis. Conclusion: Our findings help define prognosis and therapies in TM at onset. Infectious antecedents and PNS involvement associate with severe prognosis. Nerve conduction studies and lumbar MRI could improve the prognostic assessment of this condition.

scholarly journals Covid-19 post-infectious acute transverse myelitis responsive to corticosteroid therapy: report of two clinical cases

2021 ◽  
Author(s):  
Thaís de Maria Frota Vasconcelos ◽  
Danilo Nunes Oliveira ◽  
Glauber de Menezes Ferreira ◽  
Fabrícia Carneiro Torres ◽  
José Daniel Vieira de Castro ◽  
...  
Keyword(s):  
Corticosteroid Therapy ◽  
Transverse Myelitis ◽  
Acute Transverse Myelitis ◽  
Post Infectious ◽  
Clinical Cases

scholarly journals Vaccine Induced Acute Transverse Myelitis: A Case Report

2016 ◽  
Vol 13 (2) ◽  
pp. 89-91 ◽  
Author(s):  
Avinash Chandra ◽  
Reema Rajbhandari ◽  
Samir Acharya ◽  
Priya Gurung ◽  
Basant Pant
Keyword(s):  
Multiple Sclerosis ◽  
Spinal Cord ◽  
Adverse Reactions ◽  
Transverse Myelitis ◽  
Active Immunization ◽  
Acute Transverse Myelitis ◽  
Autoimmune Phenomenon ◽  
Improve Accuracy ◽  
Post Traumatic ◽  
Post Infectious

Acute transverse myelitis is a focal infl ammatory disorder of the spinal cord. One of the main etiologic factors include, multiple sclerosis, post-infectious and post-traumatic events although autoimmune phenomenon is the most common cause. Transverse Myelitis (TM) due to etiology other than Multiple Sclerosis has shown spinal cord involvement of two or more segments. Annually millions of active immunization with vaccines is carried out globally with few transverse myelitis caused because of the adverse reactions due to these vaccinations. In order to improve accuracy of reporting, research and diagnosis, the Transverse Myelitis Consortium Working Group (TMCWG) have produced criteria for the diagnosis of ATM. Here we report a case of TM in adult, diagnosed as TM consistent with the TMCWG criteria and probably this is the first ever been reported case from Nepal. Nepal Journal of Neuroscience. Vol. 13, No. 2, 2016, Page: 89-91 

scholarly journals CLINICAL EVALUATION OF PANCHKARMA MANAGEMENT ALONG WITH PHYSIOTHERAPY IN TRANSVERSE MYELITIS - A CASE STUDY

2020 ◽  
Vol p4 (05) ◽  
pp. 2453-2457
Author(s):  
Mishra Meenu ◽  
Shivhare Shwetal
Keyword(s):  
Involuntary Movement ◽  
Symptomatic Relief ◽  
Transverse Myelitis ◽  
Lower Limbs ◽  
Sensory Level ◽  
Spastic Paraplegia ◽  
Demyelinating Disorder ◽  
Bowel Movements ◽  
Post Infectious

Introduction: Transverse Myelitis is an acute, usually monophasic, demyelinating disorder affecting the spinal cord. It is usually thought to be post infectious in origin. It occurs at any age and present with a subacute paraparesis with a sensory level, accompanied by severe pain in the neck or back at the onset. The annual incidence of Transverse Myelitis ranges from 1.34 to 4.60 cases per million. In Ayurveda there is no description of a single disease which can exactly resemble with Transverse Myelitis. It can be correlated with Adhrangghata, which comes under Vatavyadhi. Aim: To study the effect of Panchkarma management with Physiotherapy in Transverse Myelitis and to find out effective Panchkarma management in Transverse Myelitis. Material & Methods: A 30-year-old male patient Vikas Dubey was visited unit OPD 31767 Kayachikitsa Govt. Ayurveda Hospital Bhopal. On 3rd June 2019 presented with Spastic Paraplegia, had involuntary movement in bilateral lower limbs along with moderate pain off and on and irregular bladder bowel movements. The patient was treated with Panchkarma along with Physiotherapy for 76 days. Assessment was done on the basis of symptomatic relief. Observation: The Panchkarma procedures along with physiotherapy yielded improvement in sensory & motor functions of patient. Conclusion: On the basis of result obtained, it can be concluded that Panchkarma along with physiotherapy can be used as effective treatment in management of Transverse Myelitis.

Spinal anesthesia in a patient on monoclonal antibody treatment: a poisoned chalice? A case report

2021 ◽  
pp. rapm-2021-102557
Author(s):  
Anneleen Herijgers ◽  
Lisa Van Dyck ◽  
Ilse Leroy ◽  
Laurens Dobbels ◽  
Peter B C Van de Putte
Keyword(s):  
Monoclonal Antibody ◽  
Spinal Anesthesia ◽  
Rare Complication ◽  
Transverse Myelitis ◽  
Motor Deficit ◽  
Prior History ◽  
High Dose ◽  
Causative Role ◽  
Antibody Treatment ◽  
Monoclonal Antibody Treatment

BackgroundParaplegia is a rare complication of spinal anesthesia.Case presentationWe report a case of a 68-year-old man who developed postoperative paraplegia and hypoesthesia after spinal anesthesia for an otherwise uncomplicated transurethral resection of the prostate. Acute transverse myelitis was diagnosed based on urgent MRI. A prior history of similar though less severe neurological symptoms after obinutuzumab treatment for follicular lymphoma suggested a potential causative role for obinutuzumab, a novel monoclonal antibody that has not been associated with such devastating neurological side effects yet. High-dose steroid treatment partially attenuated the symptoms, but debilitating hypoesthesia and motor deficit remained present 3 months postoperatively.ConclusionThe presented case warrants caution when performing neuraxial anesthesia in patients on monoclonal antibody therapies.

scholarly journals Severe necrotizing myelopathy from toxacariasis

2015 ◽  
Vol 42 (S1) ◽  
pp. S29-S29
Author(s):  
R Magun ◽  
JE Silva
Keyword(s):  
Cervical Spinal Cord ◽  
Transverse Myelitis ◽  
Elisa Test ◽  
Minimal Improvement ◽  
Oligoclonal Banding ◽  
Leg Weakness ◽  
Necrotizing Myelopathy ◽  
Serum Elisa ◽  
Post Infectious ◽  
Spinal Cord Edema

We present a 25 year old female veterinarian technician presenting with rapidly progressive quadriplegia in less then 12 hours. Her symptoms occurred at work with initially bilateral hand weakness followed by arm and leg weakness. Before the end of the day she was on a ventilator in the ICU. MRI showed a hyperintense longitudinal T2 signal extending from the cervical medullary junction to T1. Extensive cervical spinal cord edema with cord expansion was noted. CSF showed normal protein and cell count with no oligoclonal banding. A post-infectious inflammatory process causing transverse myelitis was presumed and she was given IVIG, steroids, and plasmapheresis with no improvement. A serum ELISA test for IgG to Toxocara was reactive at titre of 1:800 at 3 weeks after her initial presentation. Her serum IgE levels was elevated at 169 x 10x3 U/L (Normal <87 x 10x3 U/L). At 4 weeks, she was commenced on albendazole at 800 mg per day for two months. A repeat serum ELISA test at 6 weeks and 2 weeks into her treatment with albendazole showed a declining titre of 1:200 consistent with recent Toxocara infection. At 10 weeks, her ELISA test was non-reactive. Unfortunately she did not respond to albendazole treatment and she shows minimal improvement now 1.5 years later.

scholarly journals Acute Flaccid Myelitis in COVID-19

2020 ◽  
Vol 6 (3) ◽  
pp. 20200098
Author(s):  
Mohamed Abdelhady ◽  
Ahmed Elsotouhy ◽  
Surjith Vattoth
Keyword(s):  
Spinal Cord ◽  
Central Nervous System ◽  
Case Reports ◽  
Transverse Myelitis ◽  
Acute Disseminated Encephalomyelitis ◽  
Imaging Findings ◽  
Metabolic Complications ◽  
Acute Flaccid Myelitis ◽  
Post Infectious ◽  
Spinal Cord Imaging

Spinal cord imaging findings in COVID-19 are evolving with the increasing frequency of neurological symptoms among COVID-19 patients. Several mechanisms are postulated to be the cause of central nervous system affection including direct virus neuroinvasive potential, post infectious secondary immunogenic hyperreaction, hypercoagulability, sepsis and possible vasculitis as well as systemic and metabolic complications associated with critical illness. Only a few case reports of spinal cord imaging findings are described in COVID-19, which include transverse myelitis, acute disseminated encephalomyelitis and post-infectious Guillain Barre’ syndrome. We are describing a case of myelitis which, to the best of our knowledge, is the first reported case of myelitis in COVID-19.

348 Circumferential Correction of Post-infectious Thoracolumbar Deformity in High-risk Patients with Active Osteomyelitis

Neurosurgery ◽  
2017 ◽  
Vol 64 (CN_suppl_1) ◽  
pp. 279-279
Author(s):  
Mazda K Turel ◽  
Mena Kerolus ◽  
Ricardo B V Fontes
Keyword(s):  
Rare Complication ◽  
High Morbidity ◽  
Saps Ii ◽  
Ambulatory Status ◽  
Intraoperative Hypotension ◽  
Total Hospital Stay ◽  
Saps Ii Score ◽  
Risk Patients ◽  
The Mean ◽  
Post Infectious

Abstract INTRODUCTION Post-infectious deformity is a rare complication of osteomyelitis of the spine.Non-operative or limited operative treatment with debridement is usually futile due to destruction of the anterior column. Major reconstructive surgery may be a large undertaking with high morbidity. We describe our experience and outcomes with circumferential correction and fusion for patients with post-infectious deformity. METHODS A retrospective review of 10 consecutive patients who underwent a three-column osteotomy for thoracolumbar deformity due to bacterial osteomyelitis during an 18-month period is reported. Preoperative data included ambulatory status, CCI, clinical and infectious data, and VAS scores.Complications are reported.The severity of their immediate postoperative condition is reflected by the SAPS II score. Outcome variables included VAS scores, ambulatory status, ability to care for self, return to work status and imaging. RESULTS >The mean age was 60.5 ± 6.6 years. All patients had refractory back pain, were unable to ambulate and had confirmed diagnosis of a spinal infection.The median CCI was 5(range, 1–8) and mean VAS was 8.7 ± 1.8. All patients underwent a 3-column osteotomy with an average number of 8 levels fused. The mean EBL and operative time was 4200 mL and 8.6 hours respectively. The median SAPS II score was 25 (range, 15–52). The median ICU and total hospital stay was 4 and 13 days respectively.The most common complication was intraoperative hypotension requiring vasopressor support.Postoperative VAS was reduced to 1.5 ± 1.06, and all patients except one (preoperative paraplegia) regained ambulatory status.Mean preoperative segmental kyphosis of 30 ± 11 degrees was corrected to 10 ± 7 degrees. CONCLUSION This study suggests that extensive circumferential reconstruction for deformity originating from bacterial discitis, although a massive procedure, is effective in restoring these very sick patients to self-care and ambulatory status.Extensive reconstruction is feasible and should be considered even during the acute phase of these complex infections, especially considering how debilitating the added components of instability and deformity.

scholarly journals Spectrum of spinal cord involvement in COVID-19: A systematic review

2020 ◽  
Author(s):  
Ritwick Mondal ◽  
Shramana Deb ◽  
Gourav Shome ◽  
Upasana Ganguly ◽  
Durjoy Lahiri ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Clinical Laboratory ◽  
Case Reports ◽  
Transverse Myelitis ◽  
Systemic Review ◽  
Cochrane Library ◽  
Imaging Data ◽  
Spinal Cord Involvement ◽  
Imaging Characteristics ◽  
Post Infectious

Background and aims- Recent reports reveal incidences of spinal cord involvement in form of para-infectious or post-infectious myelitis raising potential concerns about the possibilities of SARS-CoV-2 behind the pathogenesis of spinal cord demyelination. In this study, we intend to summarise so far available pieces of evidence documenting SARS-CoV-2 mediated spinal demyelination in terms of clinical, laboratory parameters and imaging characteristics. Methodology- This review was carried out based on the existing PRISMA (Preferred Report for Systemic Review and Meta-analyses) consensus statement. Data was collected from four databases: Pubmed/Medline, NIH Litcovid, Embase and Cochrane library and Preprint servers up till 10th September, 2020. Search strategy comprised of a range of keywords from relevant medical subject headings which includes "SARS-COV-2", "COVID-19", "demyelination" etc. Results- A total of 21 cases were included from 21 case reports after screening from various databases and preprint servers. Biochemical analysis reveals that the majority of cases showed elevated CSF protein as well as lymphocytic pleocytosis. Interestingly, a majority of cases were found to be associated with long extensive transverse myelitis (LETM), and remaining cases were found to be associated with isolated patchy involvement or isolated short segment involvement or combined LETM and patchy involvement. Few cases were also found with significant co-involvement of the brain and spine based on the imaging data. Conclusion- It can be interpreted that SARS-CoV-2 may play a potential role in spinal demyelinating disorders in both para-infectious and post-infectious forms.

Acute meningitis complicated by transverse myelitis: A rare complication

2019 ◽  
Vol 3 (2) ◽  
pp. 68
Author(s):  
Ijaz Kamal ◽  
Bushra Minhas ◽  
Rania Eltahir ◽  
Abdel-Naser Elzouki
Keyword(s):  
Rare Complication ◽  
Transverse Myelitis ◽  
Acute Meningitis
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