A Rare Case of Longitudinally Extensive Transverse Myelitis Following Pfizer-BioNTech COVID-19 Vaccination with a Favourable Outcome

INTRODUCTION: mRNA COVID-19 vaccines are very safe, but rare adverse events such as transverse myelitis have been reported after COVID-19 vaccination. CASE DESCRIPTION: We report the case of 50-year-old man who presented with progressive lower extremity weakness, back pain and urinary retention after his second dose of the Pfizer COVID-19 vaccine. MRI of the spine revealed longitudinally extensive transverse myelitis (LETM). He recovered completely after treatment with intravenous methylprednisone and physical therapy. DISCUSSION: This case highlights the rare association between LETM and COVID-19 vaccines and encourages clinicians to maintain a high index of suspicion for prompt diagnosis and treatment. LEARNING POINTS: Longitudinally extensive transverse myelitis (LETM) is rare adverse events after mRNA COVID-19 vaccination. Clinicians should maintain a high index of suspicion for prompt diagnosis of vaccine-induced transverse myelitis. Vaccine-induced LETM should show marked clinical improvement after appropriate treatment.