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Spontaneous pneumorrhachis and transverse myelitis complicating purulent meningitis.

Amara B, Boujraf S, Benzagmout M, Labib S, Harandou M - J Glob Infect Dis (2013)

Bottom Line: 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.Although the usual evolution is favorable, the occurrence of serious complications is possible.

View Article: PubMed Central - PubMed

Affiliation: Department of Pneumology, University Hospital of Fez, Fez, Morocco.

ABSTRACT
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.

No MeSH data available.


Related in: MedlinePlus

The thoracic computed tomography (CT) scan in axial slice of the dorsal spine showing a lateral pneumorrhachis, pneumomediastinum, and cutaneous emphysema
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Figure 2: The thoracic computed tomography (CT) scan in axial slice of the dorsal spine showing a lateral pneumorrhachis, pneumomediastinum, and cutaneous emphysema

Mentions: The thorax X-ray showed a pneumomediastinum in the left paratracheal border along the left edge of the heart; the image also showed subcutaneous emphysema without associated pneumothorax [Figure 1]. Evermore, thorax CT scan confirmed all abnormalities described in the thorax X-ray and revealed the presence of air collection in the spinal canal between C7 and D6 levels [Figure 2]. The laryngoscopy, bronchoscopy, and digestive opacification did not show any abnormality in the respiratory-digestive tracts. These invasive gestures were achieved under general anesthesia without remarkable event.


Spontaneous pneumorrhachis and transverse myelitis complicating purulent meningitis.

Amara B, Boujraf S, Benzagmout M, Labib S, Harandou M - J Glob Infect Dis (2013)

The thoracic computed tomography (CT) scan in axial slice of the dorsal spine showing a lateral pneumorrhachis, pneumomediastinum, and cutaneous emphysema
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3958990&req=5

Figure 2: The thoracic computed tomography (CT) scan in axial slice of the dorsal spine showing a lateral pneumorrhachis, pneumomediastinum, and cutaneous emphysema
Mentions: The thorax X-ray showed a pneumomediastinum in the left paratracheal border along the left edge of the heart; the image also showed subcutaneous emphysema without associated pneumothorax [Figure 1]. Evermore, thorax CT scan confirmed all abnormalities described in the thorax X-ray and revealed the presence of air collection in the spinal canal between C7 and D6 levels [Figure 2]. The laryngoscopy, bronchoscopy, and digestive opacification did not show any abnormality in the respiratory-digestive tracts. These invasive gestures were achieved under general anesthesia without remarkable event.

Bottom Line: 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.Although the usual evolution is favorable, the occurrence of serious complications is possible.

View Article: PubMed Central - PubMed

Affiliation: Department of Pneumology, University Hospital of Fez, Fez, Morocco.

ABSTRACT
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.

No MeSH data available.


Related in: MedlinePlus