[A case of the myelitis due to Toxocara canis infection complicated with cervical spondylosis].
A 59-year-old male had suffered from numbness of the hands for 7 months. With a diagnosis of cervical spondylosis, he had been treated conservatively at a nearby clinic. After he fell off his bicycle, the numbness intensified and limb weakness developed. Cervical MRI revealed spinal cord compression at the C4/5 and C5/6 levels due to cervical spondylosis with prominent edema in the spinal cord spreading from the C4 to C6 level. The edema was very serious. Therefore, we suspected that the traumatic spinal injury underlying the cervical spondylosis was complicated by another disease. Cervical spinal angiography revealed no apparent vascular disorder. Contrast enhanced MRI showed a small enhanced area in the spinal cord at the C5 level. Because of the rapid progression of gait disturbance, expansive laminoplasty was performed without further examination. Although remarkable amelioration of the symptoms was seen just after the surgery, the symptoms worsened again about 1 month later. The patient's clinical history was reconsidered, revealing that he likes raw bovine liver. Serological examination, because of suspicion of parasitic infection showed elevated titers of anti-Toxocara canis antibody in the serum and cerebrospinal fluid. Administration of albendazole improved the clinical symptoms, and normalized the serological and MRI findings. Myelitis due to T canis infection is a rare disease. For an early and accurate diagnosis, it is important to be fully aware of this disease and to include detailed information on food preferences and pet-keeping in the process of compiling a clinical history.
Mitsuhashi
Yutaka
Y
Department of Neurosurgery, Izumi Municipal Hospital, Osaka, Japan.
Naitou
Kentarou
K
Yamauchi
Shigeru
S
Naruse
Hirotsune
H
Matsuoka
Yoshimi
Y
Nakamura-Uchiyama
Fukumi
F
Hiromatsu
Kenji
K
D000818:Animals; D002574:Cervical Vertebrae; D003937:Diagnosis, Differential; D005247:Feeding Behavior; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009187:Myelitis / Q000175:diagnosis / Q000209:etiology / Q000469:parasitology*; D013128:Spinal Osteophytosis / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D017166:Toxocara canis; D014120:Toxocariasis / Q000150:complications*