Meningococcal meningitis with myelopathy: case report and review of literature

Neisseria meningitis is a common etiological agent in bacterial meningitis in humans. Common complications associated with meningococcal meningitis include cranial nerve palsies, hydrocephalus, seizures, stroke, cerebritis or brain abscesses. Spinal cord dysfunction is a very rare complication of meningococcal meningitis and its occurrence is limited to case reports only. We report such a case along with a review of available literature and underlying pathogenetic mechanisms. Case report: Our patient diagnosed as a case of meningococcal meningitis developed multiple cranial nerve palsies followed by flaccid paraplegia with bowel bladder involvement during the recovery phase of the disease. Spine MRI showed mild cord edema and diffuse patchy areas of altered intramedullary signal intensity in dorsal cord suggestive of myelitis. The patient was treated with antibiotics and intravenous methyl-prednisolone along with supportive physiotherapy. His neurological deficits showed marked improvement on subsequent follow up.