A 40-year-old man presented with increasing lethargy, malaise, fever and sweating, which were associated with tingling and altered sensation beginning in his distal extremities, toes and fingers, before spreading proximally, ultimately resulting in an inability to bear weight. These symptoms followed a mild flu-like illness and recent foreign travel (Fig. 1).

Fig. 1
figure 1

a Sagittal T1-weighted MRI of the lumbar spine. The arrow points to the lumbar nerve roots. b T1-weighted MRI of the lumbar spine following administration of gadolinium

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