An Interesting Case of Acute Transverse Myelitis Secondary to Hepatitis C and Tricuspid Valve Endocarditis: A Case Report.

Acute transverse myelitis (ATM) is a neurological disorder characterized by inflammation of the spinal cord, often resulting in sensory, motor, and autonomic dysfunction. Herein, we present a unique case of acute transverse myelitis secondary to hepatitis C virus (HCV) infection complicating infective endocarditis (IE), a rarely reported association. A 29-year-old female presented with progressive lower extremity weakness, urinary retention, and sensory disturbances. Clinical examination revealed bilateral lower limb weakness with diminished deep tendon reflexes and sensory loss below the T8 level. Magnetic resonance imaging (MRI) of the spine demonstrated T2 hyperintensity spanning multiple spinal segments consistent with transverse myelitis. Further investigations revealed the presence of HCV infection with evidence of active viremia. Additionally, echocardiography demonstrated vegetation on the tricuspid valve consistent with IE. The patient underwent a thorough infectious workup, which confirmed the diagnosis of IE as blood cultures showed growth of methicillin-sensitive Staphylococcus aureus (MSSA). This case highlights the importance of considering acute transverse myelitis as a potential neurological complication of HCV infection, particularly in the context of IE.