Hameed Sajid, Memon Mubashar, Imtiaz Hina, Kanwar Dureshahwar
Neurology, Aga Khan University Hospital, Karachi, Sindh, Pakistan.
BMJ Case Rep. 2019 Oct 10;12(10):e231745. doi: 10.1136/bcr-2019-231745.
Chikungunya viral (CHIKV) fever is often a self-limiting febrile illness associated with severe debilitating arthralgia. Neurological complications associated with CHIKV, although rare, have been reported in literature; however, longitudinally extensive transverse myelitis (LTEM) is rarely associated with it. We present a case of a middle-aged man with a 1-week history of low-grade fever and arthralgia followed by urinary retention and quadriplegia. A sensory level was noted at T2. On subsequent investigations, he was diagnosed with LETM. Although LETM is commonly seen in patients with neuromyelitis optica, the other possible etiologies are inflammatory and parainfectious. To date, only two cases of LETM are reported worldwide in association with CHIKV fever and this is the first case from Pakistan. With frequent chikungunya outbreaks, neurological complications are increasingly seen in clinical practice. The knowledge of these associations will result in their early diagnosis and treatment.
基孔肯雅病毒（CHIKV）热通常是一种自限性发热疾病，伴有严重的使人衰弱的关节痛。与CHIKV相关的神经系统并发症虽然罕见，但文献中已有报道；然而，纵向广泛横贯性脊髓炎（LTEM）很少与之相关。我们报告一例中年男性病例，患者有1周的低热和关节痛病史，随后出现尿潴留和四肢瘫痪。在T2水平发现感觉平面。后续检查显示，他被诊断为LTEM。虽然LTEM常见于视神经脊髓炎患者，但其他可能的病因是炎症性和感染后性的。迄今为止，全球仅报告了两例与CHIKV热相关的LTEM病例，这是巴基斯坦的首例。随着基孔肯雅热疫情频繁爆发，临床实践中越来越多地见到神经系统并发症。了解这些关联将有助于早期诊断和治疗。
