ABSTRACT
Although infectious myelopathies are rare, timely and accurate diagnosis is essential
to improving outcome. There are a number of organisms that may cause infectious myelopathies,
including human immunodeficiency virus (HIV), human T-cell lymphotropic virus type
I (HTLV-I), herpesviruses, enteroviruses, Treponema pallidum, Mycobacterium tuberculosis, fungi, and parasites. Vacuolar myelopathy, the most common form of spinal cord disease
in HIV-infected individuals, is underrecognized clinically. The failure to diagnose
this condition is generally a consequence of the attribution of the lower extremity
weakness and paresthesias to general debility and concomitant peripheral neuropathy.
Tropical spastic paraparesis or HTLV-I-associated myelopathy involves the pyramidal
tracts, chiefly at the thoracic level, and results in spastic lower extremity weakness
and a spastic bladder. The herpesviruses (varicella-zoster, herpes simplex type 2,
cytomegalovirus) and the enteroviruses cause myelitis. Prior to the development of
antibiotics, syphilis was the most frequent infectious cause of spinal cord disease.
In light of the broad spectrum of pathogens that may affect the spinal cord and the
variegate fashion in which these disorders may present, the physician must always
consider an infectious etiology in the differential diagnosis for the patient presenting
with myelopathy. This review addresses the infectious myelopathies by microorganism.
KEYWORDS
AIDS - HIV-associated vacuolar myelopathy - HTLV-I-associated myelopathy - cytomegalovirus
- varicella-zoster virus - tuberculosis - syphilis - tabes dorsalis - schistosomiasis
only those hours of credit that he/she actually spent in the educational activity.
