Bakir Mohamad, Rebh Fatimah
Medicine and Surgery, Alfaisal University, College of Medicine, Riyadh, SAU.
Department of Internal Medicine, Section of Infectious Diseases, Prince Mohammed Bin Abdulaziz Hospital, Riyadh, SAU.
Cureus. 2021 Sep 2;13(9):e17658. doi: 10.7759/cureus.17658. eCollection 2021 Sep.
Respiratory viral illnesses can lead to a wide variety of neurological complications. However, only a few cases of acute transverse myelitis (ATM) following severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection have been reported in the literature. Here, we report a case of ATM following SARS-CoV-2 infection in a 57-year-old male patient. The patient presented to the emergency room with lower abdominal pain, urinary retention, bilateral lower limbs weakness, and allodynia for the last four days. One week earlier, he had experienced fever, cough, and shortness of breath. On physical examination, he was vitally stable with sensory loss from the nipples down to the lower limbs bilaterally. His nasopharyngeal polymerase chain reaction for SARS-CoV-2 was positive. MRI of the spine showed an abnormal cord signal extending from the level of the D2 vertebra down to the conus medullaris. The main differential diagnosis was transverse myelitis, and the patient was started on pulse steroids for seven days. After the therapy, the condition of the patient improved with the restoration of power and sensory sensation in his lower limbs. A new MRI of the whole spine one month later showed normal morphology and signal intensity without any abnormal enhancement. The patient was discharged home with almost complete resolution of his symptoms for later follow-up in the clinic.
呼吸道病毒感染可导致多种神经系统并发症。然而,文献中仅报道了少数几例严重急性呼吸综合征冠状病毒2(SARS-CoV-2)感染后发生急性横贯性脊髓炎(ATM)的病例。在此,我们报告一例57岁男性患者在感染SARS-CoV-2后发生ATM的病例。该患者因下腹部疼痛、尿潴留、双侧下肢无力及痛觉过敏,于近四天来急诊就诊。一周前,他曾出现发热、咳嗽及呼吸急促。体格检查时,他生命体征平稳,双侧乳头以下至下肢感觉丧失。其鼻咽部SARS-CoV-2聚合酶链反应呈阳性。脊柱磁共振成像显示脊髓信号异常,从胸2椎体水平延伸至脊髓圆锥。主要鉴别诊断为横贯性脊髓炎,患者开始接受为期七天的冲击性类固醇治疗。治疗后,患者病情好转,下肢力量和感觉恢复。一个月后,全脊柱的新磁共振成像显示形态和信号强度正常,无任何异常强化。患者出院回家,症状几乎完全缓解,以便日后在门诊进行随访。