(Kiosk 3) A Case Report of a 48-year-old Female with Cauda Equina Syndrome in the Setting of Disseminated Methicillin-resistant Staphylococcus aureus Infection

Case Diagnosis: In this report, we present a case of cauda equina syndrome due to disseminated MRSA infection.

Case Description or Program Description: Disseminated Methicillin-resistant Staphylococcus aureus (MRSA) infection is a rare cause of cauda equina syndrome. In this report, we present a case of cauda equina syndrome due to disseminated MRSA infection, which was confirmed in inpatient rehabilitation via electrodiagnostic studies. This case is also interesting because this patient had multifocal neurological manifestations of her infection, and electrodiagnostic testing helped in clarifying which of these was the most significant contributor to her left leg weakness. This information was used to guide her rehabilitation plan, and was helpful in prognostication.

Setting: Acute inpatient rehabilitation unit.

Assessment/Results: We present a case report of an unusual cause of cauda equina syndrome with multifocal neurological manifestations, and discuss how electrodiagnostic testing helped to guide the care and rehabilitation of this patient while in inpatient rehab.

Discussion (relevance): With electrodiagnostic testing, we were able to clarify which of multiple neurological problems was the most significant contributor to this patient's leg weakness. We discuss how rehabilitation care may differ between different neurological diagnoses, and we discuss the role of electrodiagnostics in an inpatient setting. This case is also interesting as it demonstrates a rare cause of cauda equina syndrome, which should be considered in patients with similar histories and exam findings.

Conclusions: Inpatient rehabilitation physicians should consider the different diagnoses which may be contributing to a patient’s symptoms as they form their plan of care. Electrodiagnostic testing can play a role in this, even in the inpatient rehabilitation setting. Clarifying which of a set of neurological conditions is most prevalent in this patient's leg weakness allowed us to better discuss prognosis and better plan her rehabilitation care with regard to this.