Meningococcal myelitis

Meningococcal myelitis is a rare neurological condition characterized by inflammation of the spinal cord, which is caused by an infection with the bacterium Neisseria meningitidis. This condition can lead to severe complications, including paralysis and sensory loss, if not treated promptly and effectively. Neisseria meningitidis is better known for causing meningococcal meningitis, a more common and widely recognized infection of the membranes covering the brain and spinal cord.

Etiology

Meningococcal myelitis results from the invasion of the spinal cord by the Neisseria meningitidis bacterium. This bacterium is a leading cause of bacterial meningitis globally but less frequently causes myelitis. Transmission of Neisseria meningitidis occurs through respiratory droplets or close contact with an infected individual. Once in the bloodstream, the bacteria can breach the blood-brain barrier and infect the spinal cord, leading to myelitis.

Symptoms

The symptoms of meningococcal myelitis can vary but typically include severe back pain, muscle weakness, sensory loss, and bladder and bowel dysfunction. These symptoms result from the inflammation and damage to the spinal cord. Fever, headache, and signs of meningitis may also be present, given the common pathogen involved.

Diagnosis

Diagnosis of meningococcal myelitis involves a combination of clinical assessment, laboratory tests, and imaging studies. Lumbar puncture (spinal tap) is crucial for analyzing cerebrospinal fluid (CSF) for evidence of Neisseria meningitidis infection. Magnetic resonance imaging (MRI) of the spine can reveal inflammation and other abnormalities indicative of myelitis. Blood cultures may also identify the presence of Neisseria meningitidis.

Treatment

Treatment for meningococcal myelitis is primarily focused on eradicating the infection and managing symptoms. Intravenous antibiotics are administered as soon as meningococcal infection is suspected, even before the diagnosis is confirmed. Corticosteroids may be used to reduce spinal cord inflammation. Supportive care, including pain management and physical therapy, is essential for recovery and rehabilitation.

Prevention

Prevention of meningococcal myelitis involves controlling the spread of Neisseria meningitidis through vaccination and public health measures. Vaccines against Neisseria meningitidis are effective in preventing meningococcal diseases, including meningitis and, by extension, potentially myelitis. Close contacts of infected individuals may also receive prophylactic antibiotics to prevent the disease's spread.

Prognosis

The prognosis for individuals with meningococcal myelitis varies. Early diagnosis and treatment can lead to a good recovery, but some individuals may experience lasting neurological deficits. The severity of the initial infection and the speed of treatment initiation are significant factors influencing the outcome.