ABSTRACT
Thoracic disc herniations are commonly found in asymptomatic individuals, sometimes with genetic predisposition. Congenital fusions of cervical vertebrae occur in Klippel-Feil syndrome, which may be asymptomatic or cause compressive myelitis due to cervical instability or associated herniated discs. We report the case of a 72-year-old man with monophasic acute transverse myelitis probably caused by herpes simplex virus, coexistent with fused cervical vertebrae (C4-C5) and thoracic herniated discs. Establishment of the aetiology in cases of transverse acute myelitis can constitute a challenge in patients with cervical spine anomaly and disc herniations.
Subject(s)
Herpes Simplex/complications , Intervertebral Disc Displacement/complications , Klippel-Feil Syndrome/complications , Myelitis, Transverse/etiology , Thoracic Vertebrae , Acyclovir/therapeutic use , Aged , Antibodies, Viral/blood , Antibodies, Viral/immunology , Antiviral Agents/therapeutic use , Cervical Vertebrae , Herpes Simplex/diagnosis , Herpes Simplex/drug therapy , Herpes Simplex/immunology , Herpesvirus 1, Human/immunology , Herpesvirus 2, Human/immunology , Humans , Immunoglobulin G/blood , Immunoglobulin G/immunology , Immunoglobulin M/blood , Immunoglobulin M/immunology , Intervertebral Disc Displacement/diagnosis , Klippel-Feil Syndrome/diagnosis , Magnetic Resonance Imaging , Male , Myelitis, Transverse/diagnosis , Myelitis, Transverse/immunology , Remission InductionABSTRACT
Dengue is an arthropod-borne disease caused by viruses of Flaviviridae family. It poses a major public health burden in tropical and sub-tropical regions. Clinical features of dengue vary from a mild flu-like disease and rash, to a potentially lethal haemorrhagic fever or shock syndrome. Hantavirus pulmonary syndrome is a rodent-born disease emerging in the American continent and is caused by viruses of the Bunyaviridae family. Potential reservoirs of these agents were described in Brazilian Central Plateau. Dengue infection is transmitted by mosquitoes, while hantaviruses are acquired by contact or inhalation of aerosolised excreta of infected rodents. Dengue and hantavirus infections have also been considered as emerging public health problems in some Indian areas; moreover, other infections mixed with dengue have been documented. The case of a Brazilian patient with hantavirus pulmonary syndrome and serologic evidence of dengue infection is described.
