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Infectious Myelopathies.

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    Infectious myelopathies are caused by various bacterial, viral, fungal, and parasitic pathogens. Understanding pathogen types, host factors, and geographic distribution aids diagnosis and treatment of these spinal cord infections.

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    Area of Science:

    • Neurology
    • Infectious Diseases
    • Microbiology

    Background:

    • Myelopathy can result from direct pathogen invasion or parainfectious autoimmune responses.
    • Certain microorganisms possess neurotropism, targeting the spinal cord, while others present with diverse neurological symptoms.

    Purpose of the Study:

    • To review bacterial, viral, fungal, and parasitic pathogens causing myelopathy.
    • To focus on myelopathies resulting from direct infection by microorganisms.

    Main Methods:

    • Review of literature on infectious agents associated with myelopathy.
    • Analysis of pathogen characteristics, host factors, and geographic distribution.
    • Identification of characteristic cerebrospinal fluid (CSF) and magnetic resonance imaging (MRI) patterns.

    Main Results:

    • Pathogens like enteroviruses (poliovirus), flaviviruses (West Nile virus), and herpesviruses (varicella-zoster virus) are implicated.
    • Immunocompromised individuals face higher risks of central nervous system infections.
    • Recent outbreaks include enterovirus D68 and Zika virus, associated with acute flaccid paralysis and myelitis.
    • Geographic variations exist, with Lyme disease and West Nile virus prevalent in the US, and parasitic infections common in other regions.

    Conclusions:

    • A wide range of pathogens can cause infectious myelopathies.
    • Differential diagnosis and management are guided by host factors, geographic origin, clinical presentation, and diagnostic imaging (CSF and MRI).