Post-infectious Transverse Myelitis Secondary to Hand, Foot, and Mouth Disease in a Pregnant Daycare Worker

Area of Science:

• Neurology
• Infectious Diseases
• Immunology

Background:

• Transverse myelitis (TM) is a rare spinal cord inflammation with diverse causes, including infections, vaccines, and autoimmune conditions.
• Infections account for approximately half of TM cases, often linked to respiratory or gastrointestinal illnesses.
• Coxsackieviruses and enteroviruses are known pathogens, typically presenting with systemic symptoms rather than a rash.

Observation:

• A pregnant daycare worker developed longitudinally extensive TM.
• The TM followed an episode of hand, foot, and mouth disease (HFMD).
• The HFMD presented solely with the characteristic rash, lacking fever or systemic signs.

Findings:

• This case demonstrates a rare association between hand, foot, and mouth disease (HFMD) and longitudinally extensive transverse myelitis (LET M).
• The presentation of HFMD without systemic symptoms preceding LETM is unusual.
• The case suggests that even mild, rash-predominant viral infections can potentially trigger severe neurological complications like TM.

Implications:

• Highlights the importance of considering neurological complications even with seemingly mild viral infections.
• Suggests a potential need for heightened awareness and monitoring for neurological symptoms in individuals experiencing HFMD, particularly pregnant women.
• Contributes to understanding the varied clinical presentations and potential triggers of transverse myelitis.