Tags

Type your tag names separated by a space and hit enter

Pneumococcal Meningitis Complicated by Spinal Cord Dysfunction and Acute Polyradiculopathy.
Ochsner J. 2020 Summer; 20(2):219-221.OJ

Abstract

Background:

Meningitis caused by Streptococcus pneumoniae is associated with devastating clinical outcomes. A considerable number of patients will develop long-term neurologic complications. Hearing loss, diffuse brain edema, and hydrocephalus are frequently encountered. Acute spinal cord dysfunction and polyradiculopathy can develop in some patients. Case Report: A 63-year-old female was admitted to our hospital with sudden-onset bilateral lower extremity weakness. On admission, the patient had evidence of spinal cord dysfunction given the abnormal motor and sensory physical examination findings and the absent sensation with a sensory level at dermatome T4 on neurologic examination. Computed tomography myelography did not show evidence of spinal cord compression or transverse myelitis. Cerebrospinal fluid examination was positive for pneumococcal meningitis. The patient was treated with antibiotics and steroids. Nerve conduction studies demonstrated the absence of response, suggesting damage to the peripheral nerves and polyradiculopathy. The patient was treated with plasmapheresis for possible Guillain-Barré syndrome; however, she did not improve despite appropriate antibiotics, steroids, and plasmapheresis. She developed persistent quadriparesis, sensory impairments in upper and lower extremities, and bowel and bladder sphincter dysfunction.

Conclusion:

Our case demonstrates the development of spinal cord dysfunction (supported by the sudden onset of paraplegia and the presence of a sensory level) and polyradiculopathy (flaccid paralysis, ascending weakness, and absence of response in neurophysiologic studies suggesting severe damage to the peripheral nerves). The appearance of either complication is unusual, and the simultaneous occurrence of both complications is even more uncommon.

Authors+Show Affiliations

Department of Medicine, University of South Dakota Sanford School of Medicine, Sioux Falls, SD.Department of Medicine, University of South Dakota Sanford School of Medicine, Sioux Falls, SD.Department of Medicine, University of South Dakota Sanford School of Medicine, Sioux Falls, SD.Department of Internal Medicine, Wayne State University/Detroit Medical Center, Detroit, MI.Department of Internal Medicine, Wayne State University/Detroit Medical Center, Detroit, MI.Department of Internal Medicine, Wayne State University/Detroit Medical Center, Detroit, MI.Department of Medicine, Interfaith Medical Center, Brooklyn, NY.

Pub Type(s)

Case Reports

Language

eng

PubMed ID

32612480

Citation

Abdallah, Mohamed A., et al. "Pneumococcal Meningitis Complicated By Spinal Cord Dysfunction and Acute Polyradiculopathy." The Ochsner Journal, vol. 20, no. 2, 2020, pp. 219-221.
Abdallah MA, Ahmed KM, Recio-Restrepo MV, et al. Pneumococcal Meningitis Complicated by Spinal Cord Dysfunction and Acute Polyradiculopathy. Ochsner J. 2020;20(2):219-221.
Abdallah, M. A., Ahmed, K. M., Recio-Restrepo, M. V., Khalid, M., Yeddi, A., Abu-Heija, A., & Khalid, M. (2020). Pneumococcal Meningitis Complicated by Spinal Cord Dysfunction and Acute Polyradiculopathy. The Ochsner Journal, 20(2), 219-221. https://doi.org/10.31486/toj.18.0153
Abdallah MA, et al. Pneumococcal Meningitis Complicated By Spinal Cord Dysfunction and Acute Polyradiculopathy. Ochsner J. 2020;20(2):219-221. PubMed PMID: 32612480.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Pneumococcal Meningitis Complicated by Spinal Cord Dysfunction and Acute Polyradiculopathy. AU - Abdallah,Mohamed A, AU - Ahmed,Khalid Mohamed, AU - Recio-Restrepo,Maria Victoria, AU - Khalid,Mowyad, AU - Yeddi,Ahmed, AU - Abu-Heija,Ahmad, AU - Khalid,Mazin, PY - 2020/7/3/entrez PY - 2020/7/3/pubmed PY - 2020/7/3/medline KW - Meningitis–pneumococcal KW - Streptococcus pneumoniae KW - neurologic manifestations KW - paraplegia KW - polyradiculopathy SP - 219 EP - 221 JF - The Ochsner journal JO - Ochsner J VL - 20 IS - 2 N2 - Background: Meningitis caused by Streptococcus pneumoniae is associated with devastating clinical outcomes. A considerable number of patients will develop long-term neurologic complications. Hearing loss, diffuse brain edema, and hydrocephalus are frequently encountered. Acute spinal cord dysfunction and polyradiculopathy can develop in some patients. Case Report: A 63-year-old female was admitted to our hospital with sudden-onset bilateral lower extremity weakness. On admission, the patient had evidence of spinal cord dysfunction given the abnormal motor and sensory physical examination findings and the absent sensation with a sensory level at dermatome T4 on neurologic examination. Computed tomography myelography did not show evidence of spinal cord compression or transverse myelitis. Cerebrospinal fluid examination was positive for pneumococcal meningitis. The patient was treated with antibiotics and steroids. Nerve conduction studies demonstrated the absence of response, suggesting damage to the peripheral nerves and polyradiculopathy. The patient was treated with plasmapheresis for possible Guillain-Barré syndrome; however, she did not improve despite appropriate antibiotics, steroids, and plasmapheresis. She developed persistent quadriparesis, sensory impairments in upper and lower extremities, and bowel and bladder sphincter dysfunction. Conclusion: Our case demonstrates the development of spinal cord dysfunction (supported by the sudden onset of paraplegia and the presence of a sensory level) and polyradiculopathy (flaccid paralysis, ascending weakness, and absence of response in neurophysiologic studies suggesting severe damage to the peripheral nerves). The appearance of either complication is unusual, and the simultaneous occurrence of both complications is even more uncommon. SN - 1524-5012 UR - https://www.unboundmedicine.com/medline/citation/32612480/Pneumococcal_Meningitis_Complicated_by_Spinal_Cord_Dysfunction_and_Acute_Polyradiculopathy L2 - https://www.ncbi.nlm.nih.gov/pmc/articles/pmid/32612480/ DB - PRIME DP - Unbound Medicine ER -
Try the Free App:
Prime PubMed app for iOS iPhone iPad
Prime PubMed app for Android
Prime PubMed is provided
free to individuals by:
Unbound Medicine.