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Case report
Longitudinally extensive transverse myelitis with seropositive chikungunya
  1. Sajid Hameed,
  2. Mubashar Memon,
  3. Hina Imtiaz and
  4. Dureshahwar Kanwar
  1. Neurology, Aga Khan University Hospital, Karachi, Sindh, Pakistan
  1. Correspondence to Dr Sajid Hameed, drsajidhameed92{at}


Chikungunya viral (CHIKV) fever is often a self-limiting febrile illness associated with severe debilitating arthralgia. Neurological complications associated with CHIKV, although rare, have been reported in literature; however, longitudinally extensive transverse myelitis (LTEM) is rarely associated with it. We present a case of a middle-aged man with a 1-week history of low-grade fever and arthralgia followed by urinary retention and quadriplegia. A sensory level was noted at T2. On subsequent investigations, he was diagnosed with LETM. Although LETM is commonly seen in patients with neuromyelitis optica, the other possible etiologies are inflammatory and parainfectious. To date, only two cases of LETM are reported worldwide in association with CHIKV fever and this is the first case from Pakistan. With frequent chikungunya outbreaks, neurological complications are increasingly seen in clinical practice. The knowledge of these associations will result in their early diagnosis and treatment.

  • infection (neurology)
  • neuroimaging
  • infectious diseases
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  • Contributors SH gave the initial concept. SH, MM and HI had the literature search and wrote the initial draft. DK reviewed the manuscript and suggested further revisions. All authors agreed with the final manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Patient consent for publication Obtained.

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