Dr. Ashok Kumar
Geriatrics
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
Answered by
Medically reviewed by
Patient's Query
Hello doctor,
My question is on behalf of a patient. The current patient has what doctors think is a variant of meningococcal myelitis. The patient had a history of fever, cold, and tiredness (symptoms similar to mononucleosis) that started a week ago. Later on, paralysis and numbness began and have been worsening. Laboratory tests have been conducted to check for tuberculosis, but no results have been achieved. The patient is unresponsive to treatment, including steroids, antibiotics, and Prozac. Immunotherapy may have been tried as well. The paralysis is spreading, and the patient is currently on a ventilator and feeding tube. Headaches are worsening, and doctors are uncertain about the next steps, as they suspect the condition may be spreading to the brain. Plasma exchange was not considered appropriate by the doctors, given the patient's condition. Do you have any experience or suggestions for preventing the disease from worsening further?
Thank you.
Hello,
Welcome to icliniq.com.
I have read your query and understand your concerns. Although I have never had firsthand experience with a patient with meningococcal myelitis, I did observe one patient being treated and recovering from the disease during my housemanship period. I remember that the individual was administered intravenous Methylprednisolone 125 mg twice a day for three continuous days, and showed some signs of recovery by the end of the third day. Additionally, the patient underwent a culture and sensitivity test of the cerebrospinal fluid (CSF), and antibiotics were selected based on the culture report. If I recall correctly, the patient was given an injection of Ceftriaxone 2 g twice a day, and an injection of Amikacin 500 mg twice a day.
I understand that my experience is very limited regarding the specific case you mentioned, but I would recommend the use of potent steroids and antibiotics to control the spread of infection, in addition to implementing life support measures. I hope this information helps you.
Thank you for consulting with me.
You can always come back and reach me at icliniq.com.
Patient's Query
Thank you doctor for the reply,
The doctors currently think it is viral, so will antibiotics work? They believe it is a virus related to polio that they have not seen before, and therefore, they are unsure about how to treat it. They have tried antibiotics and prednisolone, but so far, they have not worked, and the infection is spreading. Are there any other medications that could work?
Hello,
Welcome back to icliniq.com.
In case there is no evidence of bacterial infection, the possibility of a viral etiology is high. In viral etiology, high-end antibiotics have no role, although steroids still have some effect on the disease pathology. In this situation, our only hope lies in plasma exchange and immunotherapy, as there are no alternatives in this regard. In my opinion, the doctors treating the patient can opt for plasma exchange, as stopping the progression of the disease is more important at this stage.
I must acknowledge that commenting on such serious illnesses is much easier for me compared to doctors who are actively participating in the treatment of the patient, and their opinion should supersede mine if there are any contradictions.
Thank you for choosing icliniq.
I am happy to help you and will always be available whenever you need me at icliniq.com.
Was this conversation helpful?
Same symptoms don't mean you have the same problem. Consult a doctor now!
Geriatrics
Related Questions
How to lead a better life with paralysis after transverse myelitis?
Preventing Hospital-Acquired and Ventilator-Associated Pneumonia
CSF Protein Testing - Decoding Neurological Mysteries
Could a CSF leak occur due to a fall that happened 14 years ago?
What is the treatment for transverse myelitis?
Implantable Ventilator - Mechanics and Future Perspectives
Disclaimer: No content published on this website is intended to be a substitute for professional medical diagnosis, advice or treatment by a trained physician. Seek advice from your physician or other qualified healthcare providers with questions you may have regarding your symptoms and medical condition for a complete medical diagnosis. Do not delay or disregard seeking professional medical advice because of something you have read on this website. Read our Editorial Process to know how we create content for health articles and queries.
This website uses cookies to ensure you get the best experience on our website. iCliniq privacy policy
