Contributions
Abstract: EP1299
Type: Poster Sessions
Abstract Category: Clinical aspects of MS - Diagnosis and differential diagnosis
Introduction: We report an unusual case of a patient who presented with a longitudinally extensive transverse myelitis (LETM) secondary to brucellosis.
Case: This previously healthy 44 year old man presented with left sided numbness. His history goes back to 2 weeks prior to presentation when he developed a progressively increasing numbness over his left side associated with gait ataxia and urinary urgency. His exam was significant for weakness of the left upper and lower extremities, bilateral hyperreflexia and sustained ankle clonus on the left. Magnetic resonance imaging (MRI) of brain and cervical spine revealed a cervical non-enhancing intramedullary lesion extending from the level of C3 to C6 with associated meningeal enhancement extending from the brainstem to the lower cervical levels. Serological studies revealed high Brucella titers (>1:640), negative anti-aquaporin 4 antibodies and vasculitis panel. Cerebrospinal fluid (CSF) showed a white blood count of 260 per µl with 62 % neutrophils, a low glucose 20 mg/dL, elevated protein (4.92 g/dl), and high Brucella titers (>1:640). Additionally, CSF showed no oligoclonal bands, and negative toxocara canis antibodies, viral and tuberculosis polymerase chain reactions, and bacterial cultures. Patient was started on ceftriaxone, rifampicin, and doxycycline.
Conclusion: Neurobrucellosis should be considered in the differential diagnosis of longitudinally extensive transverse myelitis. This is only the second reported case of neurobrucellosis presenting with LETM.
Disclosure: Bassem I Yamout: Nothing to disclose
Maya Zeineddine : Nothing to disclose
Joelle Massouh: Nothing to disclose
Georges Saab: : Nothing to disclose
Abstract: EP1299
Type: Poster Sessions
Abstract Category: Clinical aspects of MS - Diagnosis and differential diagnosis
Introduction: We report an unusual case of a patient who presented with a longitudinally extensive transverse myelitis (LETM) secondary to brucellosis.
Case: This previously healthy 44 year old man presented with left sided numbness. His history goes back to 2 weeks prior to presentation when he developed a progressively increasing numbness over his left side associated with gait ataxia and urinary urgency. His exam was significant for weakness of the left upper and lower extremities, bilateral hyperreflexia and sustained ankle clonus on the left. Magnetic resonance imaging (MRI) of brain and cervical spine revealed a cervical non-enhancing intramedullary lesion extending from the level of C3 to C6 with associated meningeal enhancement extending from the brainstem to the lower cervical levels. Serological studies revealed high Brucella titers (>1:640), negative anti-aquaporin 4 antibodies and vasculitis panel. Cerebrospinal fluid (CSF) showed a white blood count of 260 per µl with 62 % neutrophils, a low glucose 20 mg/dL, elevated protein (4.92 g/dl), and high Brucella titers (>1:640). Additionally, CSF showed no oligoclonal bands, and negative toxocara canis antibodies, viral and tuberculosis polymerase chain reactions, and bacterial cultures. Patient was started on ceftriaxone, rifampicin, and doxycycline.
Conclusion: Neurobrucellosis should be considered in the differential diagnosis of longitudinally extensive transverse myelitis. This is only the second reported case of neurobrucellosis presenting with LETM.
Disclosure: Bassem I Yamout: Nothing to disclose
Maya Zeineddine : Nothing to disclose
Joelle Massouh: Nothing to disclose
Georges Saab: : Nothing to disclose