title: Quadriplegia due to pachymeningitis, vasculitis and sepsis in a patient with rheumatoid arthritis: a case report.
abstract: We report the case of a 84-year-old man, with history of rheumatoid arthritis, admitted the Hospital for a fall and complaining of dysaesthesia and pain located to the cervical spine and arms. Within a few hours after admission, fever and acute, progressive, ascendant quadriplegia became evident. Magnetic resonance imaging (MRI) of cervical spine showed spinal canal stenosis between C4-C6 with spinal cord compression. Hemocultures resulted positive for Staphylococcus aureus. The clinical picture rapidly evolved to sepsis with a fatal multi-organ failure. An autopsy found a osteosclerosis narrowing the neurocanal at the level of C3-C6, and recent cervical medulla infarction. A histological exam revealed the presence of a suppurative pachymeningitis with local phenomenas of periradiculitis, vasculitis and thrombosis of the anterior medullar artery, associated with coagulative necrosis of the neural tissue.
authors: Division of Internal Medicine, St. Anna Hospital, Ferrara, Italy.
authors: E
authors: E
authors: Mari
authors: C
authors: C
authors: Maraldi
authors: E
authors: E
authors: Grandi
authors: M
authors: M
authors: Gallerani
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001172:Arthritis, Rheumatoid / Q000150:complications*; D006801:Humans; D008297:Male; D008581:Meningitis / Q000150:complications*; D011782:Quadriplegia / Q000209:etiology*; D018805:Sepsis / Q000150:complications*; D014657:Vasculitis / Q000150:complications*