Today, an unconscious 16-year-old boy presented with insufflation of unknown amount of heroin. Had a history of polysubstance abuse and recent relapse. Vitals at admission — 80/40 mmHg, respiratory rate 8/min, no fever. He responded well to naloxone. Soon exhibited flaccid paralysis of legs, acute urinary retention, and loss of rectal tone.
MRI revealed increased T2 signal intensity and expansion of the distal thoracic cord consistent with the diagnosis of transverse myelitis. Started on IV corticosteroid with minimal response. Can you suggest the treatment course? Should I go for comprehensive drug screening?
