title: Acute transverse myelitis as a rare manifestation of Campylobacter diarrhoea with concomitant disruption of the blood brain barrier.
abstract: We describe a case of acute transverse myelitis following Campylobacter diarrhoea in an adult. The patient presented with diplegia due to a longitudinal spinal cord lesion. The CSF demonstrated an aseptic meningitis. Oligoclonal bands and C. jejuni-specific IgG were detected in serum and cerebrospinal fluid at the beginning of the neurological illness. The patient was treated with antimicrobial therapy and steroids. A near full recovery was made and there were no relapses. C. jejuni is strongly implicated in the aetiology of acute motor axonal neuropathy and Miller Fisher syndrome through molecular mimicry of neuronal gangliosides. These gangliosides are expressed throughout the nervous system yet C. jejuni related central nervous system disease is exceedingly rare. We conclude that disruption of the blood-brain barrier was the key event in the pathogenesis of immune mediated post-infectious myelitis in our patient.
authors: Department of Neurology, Chelsea and Westminster NHS Foundation Trust, 369 Fulham Road, London SW10 9NH, UK. p.gozzard@nhs.net
authors: Paul
authors: P
authors: Gozzard
authors: David
authors: D
authors: Orr
authors: Frances
authors: F
authors: Sanderson
authors: Michael
authors: M
authors: Sandberg
authors: Angus
authors: A
authors: Kennedy
mesh_terms: D000328:Adult; D001812:Blood-Brain Barrier / Q000000981:diagnostic imaging* / Q000382:microbiology; D002169:Campylobacter Infections / Q000150:complications / Q000000981:diagnostic imaging*; D003967:Diarrhea / Q000150:complications / Q000000981:diagnostic imaging* / Q000382:microbiology; D006801:Humans; D008297:Male; D009188:Myelitis, Transverse / Q000150:complications / Q000000981:diagnostic imaging* / Q000382:microbiology; D011859:Radiography