Pneumococcal Meningitis Complicated by Spinal Cord Dysfunction and Acute Polyradiculopathy.

Area of Science:

• Neurology
• Infectious Diseases

Background:

• Meningitis caused by *Streptococcus pneumoniae* often leads to severe neurological complications.
• Common sequelae include hearing loss, brain edema, hydrocephalus, and less frequently, spinal cord dysfunction and polyradiculopathy.

Observation:

• A 63-year-old female presented with sudden bilateral lower extremity weakness, indicative of spinal cord dysfunction.
• Neurological examination revealed absent sensation with a sensory level at T4.
• Cerebrospinal fluid analysis confirmed pneumococcal meningitis; imaging ruled out spinal cord compression or transverse myelitis.

Findings:

• The patient developed polyradiculopathy, evidenced by absent nerve conduction study responses and flaccid paralysis.
• Despite treatment with antibiotics, steroids, and plasmapheresis for suspected Guillain-Barré syndrome, she experienced persistent quadriparesis and sensory deficits.
• Bowel and bladder sphincter dysfunction was also noted.

Implications:

• This case underscores the rare simultaneous occurrence of spinal cord dysfunction and polyradiculopathy secondary to pneumococcal meningitis.
• The findings emphasize the potential for devastating and persistent neurological deficits in patients with pneumococcal meningitis.
• Further research into the mechanisms and management of these severe neurological complications is warranted.