Severe Acute Transverse Myelitis With a Rapid Progression in an Infant

Acute transverse myelitis (ATM) is a rare inflammatory disorder of the spinal cord, often triggered by infections, systemic diseases, or occurring without a known cause (idiopathic). It is a diagnosis of exclusion, characterized by motor, sensory, and autonomic dysfunction, with spinal cord inflammation confirmed through cerebrospinal fluid analysis or MRI. While most children experience a favorable recovery, severe cases can lead to lasting neurological deficits. This report presents the case of a 10-month-old male who presented with severe para-infectious ATM, likely triggered by <i>Campylobacter</i> <i>spp.</i> enteritis, confirmed through fecal polymerase chain reaction. The infant developed rapid-onset motor deficits, progressing to flaccid tetraparesis and respiratory failure, needing prolonged invasive mechanical ventilation and pediatric intensive care unit admission. MRI revealed extensive spinal cord involvement from C1 to D4-D5. Despite corticosteroid therapy and immunoglobulin infusion, therapeutic plasma exchange was also performed. Recovery was slow, and the patient achieved ventilatory autonomy but continued to experience significant neurological deficits, including spastic tetraparesis, and a neurogenic bladder requiring intermittent catheterization. After 73 days, the patient was discharged but required ongoing intensive rehabilitation. This case underscores a critical episode of ATM marked by multiple adverse prognostic factors. It emphasizes the necessity of comprehensive treatment approaches, including life support, efforts to reverse the inflammatory process in the spinal cord, and extensive rehabilitation. Furthermore, it highlights the importance of collaborative healthcare teams in striving for optimal patient outcomes.