Post-infectious Necrotizing Myelitis Associated with Meningitis: Report of a Fatal Case and Review of Literature.

Abstract:

Acute post-infectious necrotizing myelitis, a rare neurological complication of bacterial meningitis, is clinically defined by acute onset of paraplegia, or quadriplegia, sensory loss and loss of sphincter control. The condition should be differentially diagnosed from vascular accidents and immunogenic demyelination. This is a case of chronic otitis media complicated with meningitis which was further complicated with acute necrotizing myelitis. An eighteen-year-old man presented with fever, headache and nausea of one day duration. He was suffering from actively purulent right sided otitis media for more than a year. Patients data were first consistent with bacterial meningitis. Empirical antibiotic therapy was started and continued in spite of the CSF cultures showing no growth due to previous administration of antibiotics for otitis media. Again the patient was complicated with acute hydrocephalus and sudden attack of quadriplegia and loss of sphincter control after 48 hours. Cervical MRI was in favor of acute necrotizing myelitis, regarding the patient's clinical situation.