Introduction

Acute transverse myelitis (ATM) refers to a rare severe acquired spinal cord inflammation, with a challenging diagnostic work-up and treatment.

Case presentation

We report the case of a 42-year-old patient who presented with loss of temperature and pain sensation beneath the C5 dermatome in her left side and reported a history of a possible respiratory tract illness 10 days ago. Within 2 days, clinical worsening was noted, compatible with Brown-Sequard syndrome. Spinal magnetic resonance imaging revealed a T2 sequence abnormal signal from level C4 to T3 and cerebrospinal fluid (CSF) studies showed only a mild pleocytosis mononuclear type. Extensive CSF and blood tests revealed only high Mycoplasma pneumoniae IgM and IgG titers. Treatment with high-dose intravenous methylprednisolone and oral azithromycin were administrated and the patient recovered completely within two months.

Discussion

We would like to highlight the importance for physicians to consider M. pneumoniae in their differential diagnosis as a potential cause when encountering patients with symptoms of ATM and inflammatory Brown-Sequard syndrome.

中文翻译：

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成人患者与肺炎支原体相关的副感染 Brown-Sequard 综合征：病例报告

介绍

急性横贯性脊髓炎（ATM）是一种罕见的严重获得性脊髓炎症，诊断和治疗具有挑战性。

案例展示

我们报告了一名 42 岁患者的病例，她出现左侧 C5 皮节下方体温下降和疼痛感，并报告 10 天前可能有呼吸道疾病史。两天内，出现临床恶化，与 Brown-Sequard 综合征相符。脊髓磁共振成像显示从 C4 到 T3 水平的 T2 序列异常信号，脑脊液 (CSF) 研究仅显示轻度单核细胞增多症。广泛的脑脊液和血液检测仅显示肺炎支原体IgM 和 IgG 滴度较高。给予大剂量静脉注射甲基强的松龙和口服阿奇霉素治疗，两个月内患者完全康复。

讨论

我们想强调，当医生遇到有 ATM 和炎症性 Brown-Sequard 综合征症状的患者时，在鉴别诊断中将肺炎支原体视为潜在病因的重要性。