P.058 Spinal arachnoiditis as a complication of cryptococcal meningitis
| العنوان: | P.058 Spinal arachnoiditis as a complication of cryptococcal meningitis |
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| المؤلفون: | O Marais, M Mezei, M Alhalabi, S Belga |
| المصدر: | Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques. 49:S23-S23 |
| بيانات النشر: | Cambridge University Press (CUP), 2022. |
| سنة النشر: | 2022 |
| مصطلحات موضوعية: | Neurology, Neurology (clinical), General Medicine |
| الوصف: | Background: Spinal arachnoiditis is a rare condition involving progressive fibrosis of the spinal arachnoid membrane and can be secondary to multiple spinal surgeries, intrathecal chemotherapy, or infection. This condition can manifest as lumbosacral radiculopathy, cauda equina syndrome, myelopathy, or syringomyelia. Methods: We present a case of a 38-year-old female with recent cryptococcal meningitis treated with amphotericin B and flucytosine, who re-presented to hospital several weeks after discharge with decreased mobility requiring a wheelchair, falls, and urinary and fecal incontinence. Results: Examination revealed lower extremity pyramidal weakness, hyperreflexia, and upgoing plantar responses. CSF analysis showed white blood cells of 147x106 cells/L, protein of 4.07 g/L, and glucose of 0.4 mmol/L. Cryptococcal antigen was positive, but fungal culture was negative x 5 days, suggesting adequate initial treatment of cryptococcal meningitis. MRI spine revealed tethering of the cervical cord posteriorly at C4-5 and tethering of the midthoracic cord anteriorly. The patient was treated with IV methylprednisolone 1 g/kg daily for 5 days without significant improvement. Conclusions: Spinal arachnoiditis secondary to infection is thought to be caused by post-infectious inflammatory response syndrome (PIRIS) and is treated with IV methylprednisolone. In spinal arachnoiditis secondary to cryptococcus, the clinical findings may be confounded by the presence of hydrocephalus or myelopathy. |
| تدمد: | 2057-0155 0317-1671 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_________::3a3da182b17c928b35c77967ab578b3e https://doi.org/10.1017/cjn.2022.159 |
| حقوق: | CLOSED |
| رقم الأكسشن: | edsair.doi...........3a3da182b17c928b35c77967ab578b3e |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 20570155 03171671 |
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