BACKGROUND: Transverse myelitis has been reported in association with vaccination, including influenza vaccination.

OBJECTIVE: To describe a case of longitudinally extensive transverse myelitis associated with vaccination with a nasal attenuated novel influenza A(H1N1) vaccine.

DESIGN: Case report.

SETTING: Sanford University of South Dakota Hospital. Patient A 27-year-old woman with longitudinally extensive transverse myelitis.

RESULTS: Four days following novel influenza A(H1N1) vaccination, the patient developed longitudinally extensive transverse myelitis. Extensive diagnostic evaluation effectively ruled out causes other than vaccination-associated transverse myelitis. Following treatment with corticosteroids and plasmapheresis, the patient made a significant recovery.

CONCLUSIONS: Transverse myelitis may be associated with vaccination against novel influenza A(H1N1). Additionally, we believe this to be the first report of longitudinally extensive transverse myelitis associated with any vaccine.