Dumic Igor, Vitorovic Danilo, Spritzer Scott, Sviggum Erik, Patel Janki, Ramanan Poornima
Department of Hospital Medicine, Mayo Clinic Health System, Eau Claire, WI, United States.
Mayo Clinic College of Medicine and Science, Rochester, MN, United States.
IDCases. 2018 Dec 29;15:e00479. doi: 10.1016/j.idcr.2018.e00479. eCollection 2019.
Acute transverse myelitis (ATM) is a rare, potentially devastating neurological syndrome that has variety of causes, infectious being one of them. Lyme disease (LD) is the most common vector borne zoonosis in the United States (U.S.). While neurologic complications of LD are common, acute transverse myelitis is an exceedingly rare complication. We present a case of a previously healthy 25-year-old man who presented with secondary erythema migrans, aseptic meningitis and clinical features of transverse myelitis including bilateral lower extremity motor and sensory deficits manifesting as weakness and numbness, urinary retention and constipation. Despite negative serum antibodies against , cerebrospinal fluid (CSF) was positive for PCR. Following treatment with methylprednisolone and ceftriaxone, he attained complete recovery apart from neurogenic bladder necessitating intermittent self-catheterization. We report rare manifestation of a common disease and emphasize the importance of considering LD in the differential diagnosis of acute transverse myelitis, particularly in residents of endemic areas.
急性横贯性脊髓炎（ATM）是一种罕见的、可能具有毁灭性的神经综合征，其病因多样，感染是其中之一。莱姆病（LD）是美国最常见的媒介传播人畜共患病。虽然莱姆病的神经并发症很常见，但急性横贯性脊髓炎是一种极其罕见的并发症。我们报告一例既往健康的25岁男性病例，该患者出现继发性游走性红斑、无菌性脑膜炎以及横贯性脊髓炎的临床特征，包括双侧下肢运动和感觉障碍，表现为无力和麻木、尿潴留及便秘。尽管血清抗……抗体阴性，但脑脊液（CSF）的……聚合酶链反应（PCR）呈阳性。经甲基泼尼松龙和头孢曲松治疗后，除了需要间歇性自我导尿的神经源性膀胱外，他完全康复。我们报告了一种常见疾病的罕见表现，并强调在急性横贯性脊髓炎的鉴别诊断中考虑莱姆病的重要性，特别是在流行地区的居民中。
