Longitudinally extensive transverse myelitis following vaccination with nasal attenuated novel influenza A(H1N1) vaccine.

BACKGROUND Transverse myelitis has been reported in association with vaccination, including influenza vaccination. OBJECTIVE To describe a case of longitudinally extensive transverse myelitis associated with vaccination with a nasal attenuated novel influenza A(H1N1) vaccine. DESIGN Case report. SETTING Sanford University of South Dakota Hospital. Patient A 27-year-old woman with longitudinally extensive transverse myelitis. RESULTS Four days following novel influenza A(H1N1) vaccination, the patient developed longitudinally extensive transverse myelitis. Extensive diagnostic evaluation effectively ruled out causes other than vaccination-associated transverse myelitis. Following treatment with corticosteroids and plasmapheresis, the patient made a significant recovery. CONCLUSIONS Transverse myelitis may be associated with vaccination against novel influenza A(H1N1). Additionally, we believe this to be the first report of longitudinally extensive transverse myelitis associated with any vaccine.