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Life Threatening? No
Write-up: 2 days after 2nd dose of Gardasil, patient developed dysesthesia in arm and decrease in grip strength, leg weakness, and difficulty voiding urine. Progressed to inability to ambulate within 5 hours. Patient admitted to Medical Center. MRI revealed inflammation around spinal cord consistent with transverse myelitis vs. Guillain Barre syndrome. Clinical physical exam supported diagnosis of Transverse Myelitis. Patient treated with IV Methylprednisolone 250mg q6hr x 5 days and subsequent oral steroid taper. Over course of hospitalization, currently 7 days in duration and continuing, patient has regained some upper extremity strength and improvement in sensory symptoms. Minimal lower extremity strength recovery at this point. Throughout course of hospitalization, patient has required bladder catheterization due to inability to void urine.11/13/07-records received for DOS 9/26-10/17/07-DC DX: Transverse myelitis. Urinary tract infection (UTI). Presented to ED with 24 hour history of progressive weakness and numbness. Unable to walk. Received Gardasil 2 dys prior to symptoms and tick bite 2 weeks prior to admission. She was also on a camping trip 5 days prior to admission. PE: weak grip strength, wrist flexors and extensors normal. Right leg proximal flexor strength 2/6 and left leg strength 0/5. Distal right leg strength 0/5. Subjective numbness at T4 and below. Reflexes 1+ bilaterally in upper and lower extremities. No dysarthria. High dose steroid treatment. PlasmapheresisTransferred to rehab facility
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