Acute Transverse Myelitis Associated with Salmonella Bacteremia: A Case Report

Abstract

Patient: Female, 28Final Diagnosis: Acute transverse myelitisSymptoms: Ascending paralysisMedication: —Clinical Procedure: —Specialty: Infectious DiseasesObjective:Rare diseaseBackground:Acute transverse myelitis (ATM) is an uncommon and often overlooked complication of certain bacterial and viral infections that can have a rapid onset and result in severe neurological deficits.Case Report:This case report describes a previously healthy 28-year-old woman who presented to the trauma center after developing acute paralysis and paresthesias of all four extremities within the span of hours. The initial presumptive diagnosis was spinal cord contusion due to a fall versus an unknown mechanism of trauma, but eventual laboratory studies revealed Salmonella bacteremia, indicating a probable diagnosis of parainfectious ATM.Conclusions:This case illustrates the importance of considering the diagnosis of parainfectious ATM in patients presenting with acute paralysis with incomplete or unobtainable medical histories.

Increased risk of non-multiple sclerosis demyelinating syndromes in patients with preexisting septicaemia: a nationwide retrospective cohort study

“…Therefore, T cell-mediated autoimmunity could be triggered by microbial peptides that have proper structural resemblance to self-peptides. There are case reports of CNS demyelinating diseases after infection with viral or bacterial pathogens, such as Salmonella bacteremia,12 Epstein-Barr virus4 and influenza virus 5. Moreover, anti-MOG antibodies have been discovered in patients with ADEM5 or longitudinally extensive transverse myelitis4 following viral infection.…”

Post‐infectious transverse myelitis in an older adult: A rare complication of Klebsiella bacteremia

“…1,5 Symptoms have been reported to occur as early as hours to days after an infection. 2,6 It is unclear in the present case whether his symptoms were already present on admission, which might have contributed to his decline in function. The possibility of neuromyelitis optica, while being an important differential, is less likely due to the lack of core clinical characteristics required in its consensus criteria and the predilection that TM in neuromyelitis optica occurs >80% in the cervical cord, as noted in one study.…”

“…2 A case documenting the occurrence of TM after an episode of Salmonella bacteremia has recently been reported. 6 The pathophysiology of post-infectious TM has been postulated to be that of: (i) a molecular mimicryin which autoantibodies are formed after exposure to an infectious antigen; and (ii) activation of lymphocytes by microbial super-antigens resulting in an over-drive of the immune system. 1,5 Symptoms have been reported to occur as early as hours to days after an infection.…”

Salmonella enterica subspecies houtenae as an opportunistic pathogen in a case of meningoencephalomyelitis and bacteriuria in a dog

“…In children, meningitis is of particularly high risk in infants less than 6 months of age [22]. While meningitis is the most common presentation for Salmonella CNS infections, a few case reports have identified NTS as the etiologic agent for acute transverse myelitis [27,28]. No serotype has been found to have a greater predilection for the CNS compared to others [29], although Salmonella Enteridis Group D1 was reported to be the most common agent in one report of Samonella meningitis in children [30].…”