Vikhe Vikram B, Lapsiwala Vivek H, Faruqi Ahsan A, Kore Tejas, Chakraborty Ahanaa
General Medicine, Dr. D. Y. Patil Medical College, Hospital and Research Centre, Dr. D. Y. Patil Vidyapeeth (Deemed to Be University), Pune, IND.
Cureus. 2024 Dec 8;16(12):e75312. doi: 10.7759/cureus.75312. eCollection 2024 Dec.
Acute transverse myelitis (ATM) is a neurological disorder characterized by inflammation of the spinal cord, often resulting in sensory, motor, and autonomic dysfunction. Herein, we present a unique case of acute transverse myelitis secondary to hepatitis C virus (HCV) infection complicating infective endocarditis (IE), a rarely reported association. A 29-year-old female presented with progressive lower extremity weakness, urinary retention, and sensory disturbances. Clinical examination revealed bilateral lower limb weakness with diminished deep tendon reflexes and sensory loss below the T8 level. Magnetic resonance imaging (MRI) of the spine demonstrated T2 hyperintensity spanning multiple spinal segments consistent with transverse myelitis. Further investigations revealed the presence of HCV infection with evidence of active viremia. Additionally, echocardiography demonstrated vegetation on the tricuspid valve consistent with IE. The patient underwent a thorough infectious workup, which confirmed the diagnosis of IE as blood cultures showed growth of methicillin-sensitive Staphylococcus aureus (MSSA). This case highlights the importance of considering acute transverse myelitis as a potential neurological complication of HCV infection, particularly in the context of IE.
急性横贯性脊髓炎（ATM）是一种以脊髓炎症为特征的神经系统疾病，常导致感觉、运动和自主神经功能障碍。在此，我们报告一例罕见的丙型肝炎病毒（HCV）感染继发急性横贯性脊髓炎合并感染性心内膜炎（IE）的独特病例。一名29岁女性出现进行性下肢无力、尿潴留和感觉障碍。临床检查发现双侧下肢无力，腱反射减弱，T8水平以下感觉丧失。脊柱磁共振成像（MRI）显示多个脊髓节段T2高信号，符合横贯性脊髓炎表现。进一步检查发现存在HCV感染且有病毒血症活动证据。此外，超声心动图显示三尖瓣赘生物，符合感染性心内膜炎表现。患者接受了全面的感染性检查，血培养显示甲氧西林敏感金黄色葡萄球菌（MSSA）生长，确诊为感染性心内膜炎。该病例强调了将急性横贯性脊髓炎视为HCV感染潜在神经系统并发症的重要性，尤其是在感染性心内膜炎的背景下。
