Association of dengue with longitudinally extensive transverse myelitis and subarachnoid hemorrhage: An unusual presentation

Abstract

Association of dengue fever with transverse myelitis is a rare phenomenon; involvement of a long segment is even rarer. We describe a middle-aged female who presented with weakness of bilateral lower limbs and urinary retention 4 days after recovery from dengue fever. She, in addition, had a sensory level up to the level of nipples. Magnetic resonance imaging confirmed the diagnosis of longitudinally extensive transverse myelitis. Besides, the patient had spontaneous subarachnoid hemorrhage (SAH) in the absence of dengue hemorrhagic fever. The patient was started on steroids along with rehabilitation. Our case highlights the extensive involvement of spinal cord in the postinfectious phase of dengue and inclusion of this arboviral disease in the differential diagnoses of myelitis as well as an etiology of SAH.

Acute Transverse Myelitis as an Unusual Complication of Dengue Fever: A Case Report and Literature Review

“…Of those, 32 patients were male, and the mean age of presentation was 33.1 years, with an average time of 11.7 days from dengue to the first onset of neurological symptoms of transverse myelitis [4]. We have tabulated the reported cases of transverse myelitis complicated by dengue fever reported after 2018 (Table 3) [3,[7][8][9][10][11]. The pathophysiology of dengue fever-induced transverse myelitis is not yet defined.…”