# Post-dengue transverse myelitis: a challenging case of neurological and therapeutic evidence

## TL;DR

A man developed spinal inflammation after dengue, showing how the virus can trigger neurological issues through immune reactions.

## Contribution

This case highlights post-dengue transverse myelitis as an immune-mediated complication with potential for recovery through early treatment.

## Key findings

- MRI showed spinal cord lesions consistent with transverse myelitis after dengue infection.
- Inflammatory CSF and positive dengue serology supported an immune-mediated cause.
- Treatment with steroids and rehabilitation led to neurological improvement.

## Abstract

Dengue is an arbovirus with significant global prevalence that can lead to severe neurological complications, such as longitudinally extensive transverse myelitis (LEMT).

We describe a 36-year-old man who developed sudden paraparesis and urinary retention approximately ten days after dengue infection. MRI revealed longitudinal hyperintense lesions in the cervical and thoracic spinal cord. Cerebrospinal fluid analysis revealed an inflammatory pattern and dengue serology was positive. The patient was treated with intravenous methylprednisolone and rehabilitation, leading to gradual neurological improvement and functional recovery.

Post-dengue transverse myelitis may result from parainfectious or post-infectious autoimmune mechanisms, often accompanied by demyelination and spinal cord inflammation. The low rate of DENV IgM in the CSF reinforces the immune-mediated hypothesis. Prognosis varies depending on the early intervention and the extent of spinal injury. Underreporting remains a challenge, and future studies should explore biomarkers and develop standardized management protocols.