Table 1 Comparison of the clinical features, investigation findings and the treatment response of both patients
From: Case report long segment myelitis secondary to neuro melioidosis
1st Patient | 2nd Patient | |
|---|---|---|
Clinical Presentation | Right sided upper and lower limb weakness rapidly evolving into quadripareseis with brainstem involvement | Bilateral lower limb paraparesis |
CSF Findings | Protein – Elevated CSF Glucose drop (< 50% of blood glucose)- present Cells- No cellular reaction in 1st sample, Significantly increased neutrophils in 2nd sample CSF ADA- Elevated 26U/L | Protein – Elevated CSF Glucose drop(< 50% of blood glucose)- Absent Cells- Elevated lymphocytes CSF ADA- Normal |
MRI Spine | Long segment myelitis with contrast enhancement extending up to medulla | Long segment myelitis with contrast enhancement |
MRI Brain | 1st Report- Normal 2nd Report- linear enhancement along the corticospinal tracts, Contrast enhancement of trigeminal nerves | Normal |
CSF Culture | positive for Burkholderia pseudomallei | Negative for Burkholderia pseudomallei |
Serum melioidosis antibody | 1:320 | 1:640 |
Treatment response | Poor clinical response | Excellent clinical response |