Post-infective transverse myelitis following Streptococcus pneumoniae meningitis with radiological features of acute disseminated encephalomyelitis: a case reportReportar como inadecuado




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Journal of Medical Case Reports

, 6:313

First Online: 19 September 2012Received: 01 May 2012Accepted: 19 July 2012DOI: 10.1186-1752-1947-6-313

Cite this article as: Williams, T. & Thorpe, J. J Med Case Reports 2012 6: 313. doi:10.1186-1752-1947-6-313

Abstract

IntroductionPost-infectious autoimmune demyelination of the central nervous system is a rare neurological disorder typically associated with exanthematous viral infections. We report an unusual presentation of the condition and a previously undocumented association with Streptococcus pneumonia meningitis.

Case presentationA 50-year-old Caucasian woman presented to our facility with an acute myelopathy three days after discharge following acute Streptococcus pneumoniae meningitis. Imaging studies of the spine ruled out an infective focus and no other lesions were seen within the cord. Diffuse, bilateral white matter lesions were seen within the cerebral hemispheres, and our patient was diagnosed as having a post-infective demyelination syndrome that met the diagnostic criteria for an acute transverse myelitis. Our patient clinically and radiologically improved following treatment with steroids.

ConclusionsThe novel association of a Streptococcus pneumoniae infection with post-infectious autoimmune central nervous system demyelination should alert the reader to the potentially causative role of this common organism, and gives insights into the pathogenesis. The unusual dissociation between the clinical presentation and the location of the radiological lesions should also highlight the potential for the condition to mimic the presentation of others, and stimulates debate on the definitions of acute transverse myelitis and acute disseminated encephalomyelitis, and their potential overlap.

KeywordsPost-infective demyelination Transverse myelitis Acute disseminated encephalomyelitis Pneumococcal meningitis Streptococcus pneumoniae Electronic supplementary materialThe online version of this article doi:10.1186-1752-1947-6-313 contains supplementary material, which is available to authorized users.

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Autor: Thomas Williams - John Thorpe

Fuente: https://link.springer.com/



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