TY - JOUR
T1 - Neuromyelitis Optica Presenting as Infectious Meningoencephalitis
T2 - Case Report and Literature Review
AU - Tfaily, Mohamad Ali H.
AU - Titanji, Boghuma
AU - Schniederjan, Matthew J.
AU - Goodman, Abigail
AU - Lava, Neil S.
AU - Pouch, Stephanie M.
AU - Collins, Matthew H.
AU - Adelman, Max W.
N1 - Publisher Copyright:
© 2020 Southern Society for Clinical Investigation
PY - 2021/4
Y1 - 2021/4
N2 - In this patient-focused review, we present a 34-year-old previously healthy man admitted for fever and headache two weeks after a motor vehicle accident. On admission, his workup was concerning for meningoencephalitis based on elevated cerebrospinal fluid (CSF) white blood cell count and elevated CSF protein. He was admitted for management of meningoencephalitis. During his course, no causative infectious agent was identified despite an extensive workup. He additionally underwent an autoimmune and paraneoplastic workup that was negative. During his hospitalization, he developed acute transverse myelitis manifested by bilateral lower extremity paralysis. After four weeks marked by persistent clinical deterioration, brain biopsy was performed. Pathologic examination was consistent with neuromyelitis optica spectrum disorder (NMOSD). In this case report and literature review, we explore the presentations of NMOSD that mimic an infection. Clinicians should be aware of the possibility of NMOSD masquerading as infectious meningoencephalitis or acute transverse myelitis.
AB - In this patient-focused review, we present a 34-year-old previously healthy man admitted for fever and headache two weeks after a motor vehicle accident. On admission, his workup was concerning for meningoencephalitis based on elevated cerebrospinal fluid (CSF) white blood cell count and elevated CSF protein. He was admitted for management of meningoencephalitis. During his course, no causative infectious agent was identified despite an extensive workup. He additionally underwent an autoimmune and paraneoplastic workup that was negative. During his hospitalization, he developed acute transverse myelitis manifested by bilateral lower extremity paralysis. After four weeks marked by persistent clinical deterioration, brain biopsy was performed. Pathologic examination was consistent with neuromyelitis optica spectrum disorder (NMOSD). In this case report and literature review, we explore the presentations of NMOSD that mimic an infection. Clinicians should be aware of the possibility of NMOSD masquerading as infectious meningoencephalitis or acute transverse myelitis.
KW - Acute transverse myelitis
KW - Meningoencephalitis
KW - Neuromyelitis optica spectrum disorder
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U2 - 10.1016/j.amjms.2020.12.011
DO - 10.1016/j.amjms.2020.12.011
M3 - Review article
C2 - 33342552
AN - SCOPUS:85097896553
SN - 0002-9629
VL - 361
SP - 534
EP - 541
JO - American Journal of the Medical Sciences
JF - American Journal of the Medical Sciences
IS - 4
ER -