Open AccessSpontaneous pneumorrhachis and transverse myelitis complicating purulent meningitis
Author(s) -
B. Amara,
Saïd Boujraf,
Mohammed Benzagmout,
Smael Labib,
Mustapha Harandou
Publication year - 2013
Publication title -
journal of global infectious diseases
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.437
H-Index - 25
eISSN - 0974-8245
pISSN - 0974-777X
DOI - 10.4103/0974-777x.122019
Subject(s) - medicine , pneumomediastinum , spinal canal , pneumothorax , acute transverse myelitis , magnetic resonance imaging , respiratory distress , surgery , radiology , meningitis , myelitis , transverse myelitis , spinal cord , psychiatry
Pneumorrhachis is the presence of air in the spinal canal; mostly, it has an iatrogenic origin. The association of this entity with spontaneous pneumomediastinum without any pneumothorax is rarely reported in the literature. The spontaneous resorption is the usual evolution. The association to acute transverse myelitis is discussed by the authors. The patient is a 21-year-old male with pneumorrhachis associated to a spontaneous pneumomediastinum was admitted at the emergency department for bacterial meningitis. The antibiotherapy has marked the clinical profile by disappearance of the meningeal signs in the 48 h after admission. In contrast, the neurological symptoms were of marked aggravation by appearance of a tetraparesis with a respiratory distress syndrome having required artificial ventilation. The computed tomography (CT) scan showed a typical hypodensity corresponding to paramedullary air extending to several thoracic segments. The spinal magnetic resonance imaging (MRI) showed a high cervical medullary edema without signs of compression. The patient died within 15 days with a profile of vasoparalysis resistant to vasoactive drugs. Pneumomediastinum associated to pneumorrhachis and transverse myelitis complicating purulent meningitis is a rare entity. Although the usual evolution is favorable, the occurrence of serious complications is possible.