skip to main content

HAM/TSP — SCE Infectious Diseases MCQ

Instant feedback + full explanation. One question, done properly.

HardCNS InfectionHAM/TSPSCE Infectious Diseases

A 55-year-old man with known HTLV-1 infection develops progressive lower limb spastic paraparesis, urinary retention, and sensory loss. MRI spine shows thoracic cord T2 hyperintensity. CSF shows mild lymphocytic pleocytosis with HTLV-1 proviral DNA detected. What is the diagnosis?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: D — HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP)

Progressive spastic paraparesis with bladder dysfunction and thoracic cord signal change in a patient with HTLV-1 is diagnostic of HAM/TSP (HTLV-1-associated myelopathy/tropical spastic paraparesis). This is a chronic, progressive neurological disease caused by HTLV-1-driven inflammatory damage to the thoracic spinal cord. It occurs in ~3–5% of HTLV-1 carriers. There is no curative treatment; management is symptomatic (physiotherapy, spasticity management, bladder care). Corticosteroids and antiretrovirals have limited evidence.

Reference: BHIVA 2022 – HTLV guidelines; WHO 2022 – HTLV-1