Abstract:
Transverse myelitis (TM) is a frequently encountered inpatient neurological condition, usually with a broad differential of etiologies narrowed down by detailed history, temporal profile of symptom evolution, and pertinent diagnostic studies. We report a rare case of a 39-year-old man who presented with subacute onset of headaches and confusion, and three days later developed quadriplegia and areflexia. He was diagnosed with acute longitudinally extensive transverse myelitis (LETM) related to Epstein-Barr virus (EBV) superimposed on an initial presentation of streptococcal meningitis. As both etiologies are under-reported, we compare our case to the few similar cases in the literature to guide discussion of the clinical and radiologic findings of parainfectious TM related to EBV and streptococcal meningitis. Readers will have the challenge of attributing our patient\'s myelitis to one of these parainfectious sources and are encouraged to evaluate for rare infectious etiologies in acute settings.
摘要:
横向脊髓炎(TM)是一种经常遇到的住院神经系统疾病,通常有广泛的病因差异,由详细的历史缩小,症状演变的时间剖面,和相关的诊断研究。我们报告了一个罕见的病例,一个39岁的男人,他出现了亚急性发作的头痛和混乱,三天后出现四肢瘫痪和反射障碍。他被诊断出患有与爱泼斯坦-巴尔病毒(EBV)相关的急性纵向广泛性横贯性脊髓炎(LETM),最初表现为链球菌性脑膜炎。由于这两种病因的报道不足,我们将我们的病例与文献中的少数类似病例进行了比较,以指导对与EBV和链球菌性脑膜炎相关的副传染性TM的临床和放射学发现的讨论.读者将面临挑战,将我们患者的脊髓炎归因于这些副感染源之一,并鼓励他们在急性环境中评估罕见的感染性病因。