Longitudinally transverse myelitis as a rare complication of pneumococcal meningitis: case report.

Abstract

Pneumococcal meningitis is the most severe bacterial meningitis rarely complicated by acute myelitis. We report a case of a 54-year-old female who presented with pneumococcal meningoencephalitis. After eight days of hospitalization, the patient presented a sudden onset of bilateral lower leg weakness and bladder and bowel sphincter dysfunction. A neurological examination revealed a flaccid paraplegia. A magnetic resonance imaging (MRI) of the brain and the complete spinal cord was performed and showed cervical and thoracic myelitis. The patient was successfully treated with antibiotics and intravenous steroids. This case emphasizes the importance of considering myelitis as an acute complication of bacterial pneumococcal meningitis, with a good prognosis depending on early recognition and administration of appropriate therapy.