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Over 2\u00a0years, she developed a progressive myelopathy affecting predominantly the motor system. She had the picture of a \u2018person in a barrel\u2019 and died from complications. At autopsy, spinal cord revealed inflammatory infiltrates and extensive gliosis involving mainly the anterior horns. The vertebral arterial dissections may have permitted the entry of infected lymphocytes and macrophages, secreting cytokines and metalloproteinases, into the medulla progressing to the spinal cord. 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