Acute Transverse Myelitis Associated With Dengue Viral Infection

Abstract

Background: Acute transverse myelitis is a rare manifestation of dengue viral infection. Four cases have been previously reported in the literature. Objective: To report a case of a 61-year-old woman who developed acute transverse myelitis 6 days after the onset of a dengue viral infection. Findings: Magnetic resonance imaging of spinal cord showed hypersignal intensity on T2W at T9-T10. Laboratories studies revealed a high titer of hemagglutination inhibition of dengue virus. Treatment with intravenous pulse methylprednisolone and physiotherapy yielded a partial recovery, followed by complete resolution at 1 year postinfection. Conclusion: Acute transverse myelitis is a rare manifestation of dengue infection that can occur in either the peri-infectious or postinfectious phases.

Retención de orina en un paciente inmunocompetente: mielitis transversa aguda

“…Otros procesos causantes son los de origen infeccioso, que provocan una agresión directa en la médula espinal. Son muchos los microorganismos sobre los que existen casos publicados: dengue, parotiditis, sarampión, rubeóla, virus Hepatitis C, B y E, CMV, VEB, VVZ, Coxackie, Influenza, VHS, micobacterias, Mycoplasma pneumoniae, sífilis, Listeria o Borrelia 9,10 . En un número no desdeñable de ocasiones resulta complejo discernir su patogenia ya que los cuadros infecciosos o incluso las vacunaciones (difteria, tétanos, rubéola, hepatitis B, rabia, Bordetella pertussis, cólera, tifus, poliomielitis) pueden ocasionar una brusca reacción inmune que es la que finalmente produce la necrosis de la sustancia gris o la lesión de la sustancia blanca, con desmielinización perivenosa e infiltrados linfocitarios 11 .…”

Transverse Myelitis as an Unusual Complication of Dengue Fever

“…These include encephalopathy, encephalitis, febrile seizures, aseptic meningitis, intracranial hemorrhages, intracranial thrombosis, subdural effusions, mononeuropathies, polyneuropathies, and GuillainBarré syndrome. 5,6 However, spinal cord involvement following DENV infections is rare, and presents as postinfectious myelopathy, acute disseminated encephalomyelitis, or transverse myelitis (TM). 7 TM can be para-or postinfectious.…”

Acute Transverse Myelitis and Dengue: A Systematic Review

“…They may be justified by metabolic, hematological and hemodynamic changes that have occurred in the acute phase of the disease, by direct aggression of the virus to the CNS or by immunomediated processes [4][5][6]. Considering the epidemiological importance of dengue and its possible complications in tropical and subtropical countries, we seek to identify, by means of a systematic review, the associations between dengue and transverse myelitis described in literature, as well as to compare the clinical data, laboratory and epidemiological reported by these publications.…”