Singh Divya, deFisser Gavin, Samuel Sandra, Chennu Navreet T, Polhemus Laura, Rodriguez Wilson, Kafaie Jafar
Neurology, Saint Louis University School of Medicine, St. Louis, USA.
Neurology, Saint Louis University Hospital, St. Louis, USA.
Cureus. 2024 Jun 24;16(6):e63079. doi: 10.7759/cureus.63079. eCollection 2024 Jun.
Transverse myelitis (TM) is a frequently encountered inpatient neurological condition, usually with a broad differential of etiologies narrowed down by detailed history, temporal profile of symptom evolution, and pertinent diagnostic studies. We report a rare case of a 39-year-old man who presented with subacute onset of headaches and confusion, and three days later developed quadriplegia and areflexia. He was diagnosed with acute longitudinally extensive transverse myelitis (LETM) related to Epstein-Barr virus (EBV) superimposed on an initial presentation of streptococcal meningitis. As both etiologies are under-reported, we compare our case to the few similar cases in the literature to guide discussion of the clinical and radiologic findings of parainfectious TM related to EBV and streptococcal meningitis. Readers will have the challenge of attributing our patient's myelitis to one of these parainfectious sources and are encouraged to evaluate for rare infectious etiologies in acute settings.
横贯性脊髓炎（TM）是一种在住院患者中常见的神经系统疾病，通常通过详细的病史、症状演变的时间特征以及相关的诊断研究，可将病因的广泛鉴别诊断范围缩小。我们报告一例罕见病例，一名39岁男性，亚急性起病，出现头痛和意识模糊，三天后发展为四肢瘫痪和反射消失。他被诊断为与爱泼斯坦-巴尔病毒（EBV）相关的急性纵向广泛横贯性脊髓炎（LETM），叠加在最初表现为链球菌性脑膜炎之上。由于这两种病因的报道都较少，我们将我们的病例与文献中少数类似病例进行比较，以指导关于与EBV和链球菌性脑膜炎相关的感染后TM的临床和影像学表现的讨论。读者将面临将我们患者的脊髓炎归因于这些感染后病因之一的挑战，并被鼓励在急性情况下评估罕见的感染病因。
