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A Case of Transverse Myelitis Secondary to COVID-19 Infection
Rahul Borra1, Neal T Patel1, Raheel Shaikh1
1Medicine, Nova Southeastern University Dr. Kiran C. Patel College of Osteopathic Medicine, Fort Lauderdale, USA.
Abstract:
Infection with COVID-19 (SARS-CoV-2) is associated with a variety of generalized and specific symptoms, including neurological complications of both the peripheral and central nervous systems. In this case report, we present the case of a previously healthy 55-year-old woman who was diagnosed with transverse myelitis following a previous infection with COVID-19. MRI showed progressive demyelination of the cervical and thoracic spinal cord, and cerebrospinal fluid (CSF) showed increased levels of protein and red blood cells and no markers of infection, including negative polymerase chain reaction (PCR) for COVID-19 antibodies. The patient was treated with a course of methylprednisolone, multiple treatments of plasmapheresis, and ongoing treatment with rituximab, all of which were well-tolerated. She was instructed to follow up as an outpatient with the neurologist and primary care physician five to seven days after hospital discharge.
Insights
COVID-19 infection can cause neurological issues like transverse myelitis. This case report details a patient treated successfully for post-COVID-19 transverse myelitis with steroids and immunotherapy.
Area of Science:
- Neurology
- Infectious Diseases
- Immunology
Background:
- COVID-19 (SARS-CoV-2) is known to cause diverse neurological complications affecting both central and peripheral nervous systems.
- Neurological manifestations range from common symptoms to severe conditions impacting brain and spinal cord function.
Observation:
- A previously healthy 55-year-old woman developed transverse myelitis after a COVID-19 infection.
- Magnetic Resonance Imaging (MRI) revealed progressive demyelination in the cervical and thoracic spinal cord.
- Cerebrospinal fluid (CSF) analysis indicated elevated protein and red blood cells, with negative PCR for COVID-19 antibodies, ruling out active infection.
Findings:
- The patient's transverse myelitis was characterized by spinal cord demyelination post-COVID-19.
- Diagnostic workup confirmed inflammation and cell presence in CSF without detectable SARS-CoV-2 markers.
- Treatment involved methylprednisolone, plasmapheresis, and rituximab, which were well-tolerated.
Implications:
- This case highlights a rare but serious neurological complication of COVID-19.
- Effective management strategies for post-infectious transverse myelitis include immunosuppressive therapies.
- Further research is warranted to understand the mechanisms linking COVID-19 to demyelinating disorders.
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