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Neurologic exam showed brisk reflexes, upgoing plantars, and subtle T4–T5 sensory changes, following an emergency visit for acute urinary retention. MRI revealed a T2 hyperintense spinal cord signal from C3 to the conus, and cerebrospinal fluid demonstrated lymphocytosis. Treatment with high-dose intravenous methylprednisolone produced marked recovery, supporting a post-infectious trigger and emphasizing evaluation of urinary retention for central causes in young patients.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/post-infectious-acute-transverse-myelitis-in-a-covid-19-patient/455221/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/post-infectious-acute-transverse-myelitis-in-a-covid-19-patient/455221.png","ImageObject",300,407,{"name":92,"@type":93},"A glass of water","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-30","2026-09-30",true,{"@type":102,"interactionType":103,"userInteractionCount":52},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"When did the patient’s neurologic symptoms begin after COVID-19?","Question",{"text":112,"@type":113},"Neurologic symptoms appeared eight days after the initial onset of COVID-19.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"What key findings supported acute transverse myelitis in this case?",{"text":117,"@type":113},"MRI showed a T2 hyperintense signal extending from C3 to the conus, and cerebrospinal fluid analysis revealed lymphocytosis, alongside exam findings consistent with partial upper thoracic myelopathy.",{"name":119,"@type":110,"acceptedAnswer":120},"How was the patient treated, and what was the outcome?",{"text":121,"@type":113},"High-dose intravenous methylprednisolone was administered, leading to significant clinical improvement with recovery of strength and bladder and bowel function.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},455221,1790762807,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":52,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":29,"language":139,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":67,"update_tm":143,"read_time":144,"preview_page_count":4},962090760832,"https://ap-avatar.wpscdn.com/davatar_155a257f0dc6eb9ab79c44ca47cae57d","Review began 10/08/2025  \nReview ended 11/26/2025  \nPublished 12/07/2025  \n© Copyright 2025  \nFabricante et al. This is an open access article distributed under the terms of the Creative Commons Attribution License CCBY 4.0. , which permits unrestricted use , distribution , and reproduction in any medium , provided the original author and source are credited.  \nDOI: 10.7759/cureus.98649  \nOpen Access Case Report  \nPost-Infectious Acute Transverse Myelitis in a COVID-19 Patient  \nJonathan Fabricante 1 , Sophie Cooper 1, Lal Kumar 1, Azeem Alam 2  \n1. Internal Medicine, The Princess Alexandra Hospital NHS Trust, Harlow, GBR 2. Clinical Radiology, Imperial College London, London, GBR  \nCorresponding author: Jonathan Fabricante, [jonathan.fabricante@nhs.net](jonathan.fabricante@nhs.net)  \nAbstract  \nA 41-year-old man with no comorbidities presented with features consistent with a subacute partial upper thoracic myelopathy, two days after treatment in the emergency department for acute urinary retention. On examination, he was ambulatory but had an unsteady gait and lower limb weakness, with brisk reflexes, upgoing plantars, and subtle sensory changes at the T4-T5 level. The patient developed neurological symptoms eight days after the initial onset of COVID-19 . An urgent magnetic resonance imaging (MRI) of the spine demonstrated a T2 hyperintense signal extending from C3 to the conus, while cerebrospinal fluid analysis revealed lymphocytosis. Following treatment with high-dose intravenous methylprednisolone, the patient showed significant clinical improvement, with recovery of strength and bladder and bowel function. This case highlights COVID-19 as a possible post-infectious trigger for transverse myelitis and underscores the need to investigate acute urinary retention in young patients.  \nCategories: Neurology, Internal Medicine, Infectious Disease  \nKeywords: acute transverse myelitis (atm), covid 19, para-infectious covid myelitis, post-covid-19 sequelae, tranverse myelitis  \nIntroduction  \nFollowing the emergence of coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), an expanding range of systemic complications has been increasingly recognized. Although respiratory manifestations predominate, neurological complications, including anosmia, encephalopathy, stroke, and demyelinating syndromes, have also been reported [1,2] . Among these, acute transverse myelitis (ATM) is a rare but serious condition characterized by spinal cord inflammation leading to varying degrees of motor, sensory, and autonomic dysfunction [3] . Incidence of ATM is between 1.34-4.6 per million cases per year with bimodal peaks between ages 10-19 and 30-39 years old, with no gender or familial or ethnic predisposition [4] .  \nIn the context of COVID-19, ATM is hypothesized to result from either direct viral neuroinvasion, supported by occasional detection of SARS-CoV-2 RNA in cerebrospinal fluid, or a post-infectious immune-mediated mechanism, suggested by the delayed onset of neurological symptoms and favorable response to immunotherapy [5,6] . In a 2021 case report by Roman et al., 43 patients with COVID-19-associated ATM from 21 countries were documented between March 2020 and January 2021, highlighting the global occurrence yet relative rarity of this complication [7] .  \nEarly recognition and prompt treatment with high-dose corticosteroids are crucial to optimize outcomes [7] . We present a case of a previously healthy 41-year-old man who developed subacute partial thoracic myelopathy with urinary retention shortly after symptomatic COVID-19 infection. This case highlights the importance of considering post-infectious neurological complications following COVID-19 and investigating acute urinary retention in younger patients for possible central causes.  \nCase Presentation  \nA 41-year-old previously healthy man with no comorbidities presented to the Emergency Department (ED) with 24 hours of acute","cbCaibtD9IFDv0bV","https://ap.wps.com/l/cbCaibtD9IFDv0bV","pdf",1126215,"English","# Abstract\n# Introduction\n# Case Presentation\n## Initial Emergency Department presentation\n## Neurologic deterioration and reassessment\n# How to cite this article\n# Examination and initial investigations","[{\"question\":\"When did the patient’s neurologic symptoms begin after COVID-19?\",\"answer\":\"Neurologic symptoms appeared eight days after the initial onset of COVID-19.\"},{\"question\":\"What key findings supported acute transverse myelitis in this case?\",\"answer\":\"MRI showed a T2 hyperintense signal extending from C3 to the conus, and cerebrospinal fluid analysis revealed lymphocytosis, alongside exam findings consistent with partial upper thoracic myelopathy.\"},{\"question\":\"How was the patient treated, and what was the outcome?\",\"answer\":\"High-dose intravenous methylprednisolone was administered, leading to significant clinical improvement with recovery of strength and bladder and bowel function.\"}]","Post-Infectious Acute Transverse Myelitis in a COVID-19 Patient | PDF",1790742402,15]