Acute urinary retention and progressive paraplegia with genital infection: A case report of transverse myelitis

Abstract

Introduction: Transverse myelitis (TM) is a rare inflammatory disorder involving single or multiple spinal segments. There are various Infectious and parainfectious causes. Case presentation: We report the case of 29-year-old female who presented to an emergency department with acute urinary retention, progressive headache and sensory and motor deficits with a genital infection. Cerebrospinal fluid (CSF) analysis revealed WBC 75/mu L, protein 96 (15-40 mg/dL), and VZV IgG positive. The magnetic resonance image (MRI) of the spine revealed acute transverse myelitis of C4, C6/C7 and T2-T3, T4-T7. She was treated with steroid pulse therapy, intravenous antiviral therapy, antibiotics, and rehabilitation. Urinary symptoms resolved in six days and her motor deficit resolved. She had mild numbness in the thigh area 2 months later. Discussion: Identification of the causes and diagnosis of TM are challenging because there are variable clinical signs and numerous potential pathogens. Conclusion: It is essential to diagnosis TM in the early and timely phase, careful, detailed history and thorough physical examination by emergency physicians.