Espinosa-Rueda J, Muñoz-Farjas E, Roche J C
Hospital Clínico Universitario Lozano Blesa, 50009 Zaragoza, España.
Rev Neurol. 2022 Jul 1;75(1):17-20. doi: 10.33588/rn.7501.2021215.
Pneumococcal meningitis is a condition associated with a high rate of morbidity and mortality.
We report the clinical case of a 41-year-old man who, following meningitis caused by Streptococcus pneumoniae, developed subsequent complications such as thoracic transverse myelitis, which caused paralysis in the lower extremities, abolition of all sensory modalities and dysautonomic disorders, as well as an alteration of the anterior horn cells at the cervical level that produced paralysis in the upper extremities, but with preservation of sensibility. This implies the need for a differential diagnosis between what is known as 'poliomyelitis-like' disorder and acute disseminated encephalomyeloradiculitis. The examination and the radiological and neurophysiological study showed a full clinical recovery of the upper extremities, thanks in part to early neurorehabilitation.
Complications of the spinal cord within the context of infection of the central nervous system are very rare. Involvement of the anterior horn cells of the spinal cord has only been described anecdotally, and no bibliographical references have been found that associate it with S. pneumoniae.
肺炎球菌性脑膜炎是一种发病率和死亡率都很高的疾病。
我们报告了一名41岁男性的临床病例,该患者在感染肺炎链球菌导致脑膜炎后,出现了诸如胸段横贯性脊髓炎等并发症,导致下肢瘫痪、所有感觉功能丧失和自主神经功能障碍,以及颈段前角细胞改变导致上肢瘫痪,但感觉功能保留。这意味着需要对所谓的“脊髓灰质炎样”疾病和急性播散性脑脊髓神经根炎进行鉴别诊断。检查以及放射学和神经生理学研究显示上肢完全临床康复,这部分归功于早期神经康复治疗。
中枢神经系统感染情况下的脊髓并发症非常罕见。脊髓前角细胞受累仅有个案报道,未发现有文献将其与肺炎链球菌感染相关联。