Make the Dx: A viral appetizer
Key Takeaways
Can you diagnose this mystery illness?
A 6-year-old boy who was previously healthy presented to the emergency department with headache, sore throat, an earache in his left ear, neck pain, and history of fever up to 101.0°F.
He had symptoms of cough and congestion during the previous 2 weeks. Two days later, he exhibited neck weakness and imbalance, which made it hard to walk and required him to use a wheelchair.
He also experienced left facial weakness and was subsequently hospitalized due to his symptoms.
Weakness of his neck, face, and upper extremities worsened for 2 days of hospitalization and subsequently improved during the course of his stay.
Although no infectious etiology was identified per CSF and blood tests, he was treated with ceftriaxone for possible meningitis. Of note, his CSF exhibited pleocytosis, or increased cell count. A follow-up MRI was within normal limits, although a spinal MRI was indicative of myelitis.