Nieto Luis M, Narvaez Sharon I, Asthana Anantratn, Mohammed Amir, Kinnucan Jami
Internal Medicine, Wellstar Atlanta Medical Center, Atlanta, USA.
Internal Medicine, Facultad de Medicina, Universidad de Guayaquil, Guayaquil, ECU.
Cureus. 2022 Apr 5;14(4):e23834. doi: 10.7759/cureus.23834. eCollection 2022 Apr.
A 23-year-old male presented to the hospital with altered mental status (AMS) and hypoglycemia requiring admission to the ICU. He had improvement in AMS after administration of dextrose 50% and naloxone and endorsed the use of alcohol, cocaine, and marijuana that morning. It was confirmed with a positive urine toxicology screen for cocaine and tetrahydrocannabinol (THC). During this hospital admission, his physical examination was notable for paraplegia with no motor abilities from the T6 dermatome and below. Sensation was intact throughout all dermatomes but he was found to have urinary retention. Workup included an abnormal MRI showing T2 signal spanning from T2-T8, raising a high suspicion of a probable acute ischemic spinal cord infarction. Several hours after admission, the patient began to exhibit the first signs of abnormal bowel function and experienced one episode of hematemesis, prolonging his ICU stay.
一名23岁男性因精神状态改变（AMS）和低血糖入住重症监护病房（ICU）。静脉注射50%葡萄糖和纳洛酮后，他的精神状态有所改善，且承认当天上午使用过酒精、可卡因和大麻。尿液毒理学筛查可卡因和四氢大麻酚（THC）呈阳性，证实了他的吸毒情况。此次住院期间，体格检查发现他双下肢瘫痪，T6节段及以下无运动能力。所有皮节感觉均完整，但发现他有尿潴留。检查包括MRI异常，显示T2至T8节段有T2信号，高度怀疑可能是急性缺血性脊髓梗死。入院数小时后，患者开始出现肠道功能异常的最初迹象，并发生了一次呕血，延长了他在ICU的住院时间。
