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Published on: March 13, 2018
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Longitudinally extensive transverse myelitis with seropositive chikungunya
Sajid Hameed1, Mubashar Memon1, Hina Imtiaz1
1Neurology, Aga Khan University Hospital, Karachi, Sindh, Pakistan.
BMJ Case Reports
|October 13, 2019
Summary
Chikungunya viral fever can rarely cause longitudinally extensive transverse myelitis (LETM), a severe neurological complication. This case highlights the importance of recognizing this rare association for prompt diagnosis and treatment.
Area of Science:
- Neurology
- Infectious Diseases
- Clinical Case Study
Background:
- Chikungunya viral (CHIKV) fever is typically a self-limiting illness characterized by fever and arthralgia.
- Neurological complications of CHIKV are uncommon but documented.
- Longitudinally extensive transverse myelitis (LETM) is a rare neurological manifestation associated with CHIKV infection.
Observation:
- A middle-aged male presented with a week of fever and arthralgia, followed by urinary retention and quadriplegia.
- A T2 sensory level was identified.
- The patient was diagnosed with LETM.
Findings:
- This case represents the third reported instance of LETM associated with CHIKV globally and the first from Pakistan.
- LETM is more commonly associated with neuromyelitis optica but can also be inflammatory or parainfectious.
- The diagnosis of LETM was confirmed through subsequent investigations.
Implications:
- Increasing CHIKV outbreaks necessitate heightened awareness of potential neurological complications.
- Early recognition and diagnosis of CHIKV-associated LETM are crucial for timely intervention.
- Understanding this rare association aids in managing patients presenting with myelitis during or after CHIKV infection.
