Sakly Hela, Rouis Sana, Chakroun Hajer
Infectious Diseases Department, Ibn Al Jazzar University Hospital, Kairouan, Tunisia.
Faculty of Medicine of Sousse, University of Sousse, Sousse, Tunisia.
Pan Afr Med J. 2024 Sep 9;49:11. doi: 10.11604/pamj.2024.49.11.43180. eCollection 2024.
Pneumococcal meningitis is the most severe bacterial meningitis rarely complicated by acute myelitis. We report a case of a 54-year-old female who presented with pneumococcal meningoencephalitis. After eight days of hospitalization, the patient presented a sudden onset of bilateral lower leg weakness and bladder and bowel sphincter dysfunction. A neurological examination revealed a flaccid paraplegia. A magnetic resonance imaging (MRI) of the brain and the complete spinal cord was performed and showed cervical and thoracic myelitis. The patient was successfully treated with antibiotics and intravenous steroids. This case emphasizes the importance of considering myelitis as an acute complication of bacterial pneumococcal meningitis, with a good prognosis depending on early recognition and administration of appropriate therapy.
肺炎球菌性脑膜炎是最严重的细菌性脑膜炎,很少并发急性脊髓炎。我们报告一例54岁女性,表现为肺炎球菌性脑膜脑炎。住院八天后,患者突然出现双侧小腿无力以及膀胱和肠道括约肌功能障碍。神经系统检查显示为弛缓性截瘫。对脑部和整个脊髓进行了磁共振成像(MRI)检查,结果显示为颈段和胸段脊髓炎。该患者通过抗生素和静脉注射类固醇成功治愈。此病例强调了将脊髓炎视为细菌性肺炎球菌性脑膜炎急性并发症的重要性,其预后良好取决于早期识别和给予适当治疗。