[Cranial multineuritis and transverse myelitis as complications of pneumococcal meningitis]

【肺炎球菌性脑膜炎并发颅神经炎和横贯性脊髓炎】

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Abstract

INTRODUCTION: Pneumococcal meningitis is a condition associated with a high rate of morbidity and mortality. CASE REPORT: 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. CONCLUSIONS: 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.

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