Bilateral simultaneous facial palsy following scrub typhus meningitis: A case report and literature review

The Kaohsiung Journal of Medical Sciences - Tập 27 - Trang 573-576 - 2011
Wei-Ru Lin1, Tun-Chieh Chen1,2, Chun-Yu Lin1,2, Po-Liang Lu1,2, Yen-Hsu Chen1,2,3
1Division of Infectious Diseases, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
2Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
3Tropical Medicine Research Center, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan

Tóm tắt

AbstractScrub typhus is widely distributed across the Asia‐Pacific region, Taiwan included. The clinical manifestations and complications of scrub typhus vary and the illness ranges in severity from mild to fatal. The etiology of facial nerve palsy varies and infectious agents have been associated with this condition. Rickettsiae species have, however, rarely been reported as the causative agents. We report the case of a 49‐year‐old man who had fever, malaise, headache, oligouria and tea‐colored urine. Bilateral pneumonitis, acute renal failure, acalculous cholecystitis and aseptic meningitis were diagnosed after a series of examinations. The patient recovered after doxycycline treatment but he developed bilateral facial palsy during the convalescent phase, which improved after the administration of a steroid. The diagnosis of infection with Orientia tsutsugamushi was confirmed by the Taiwan Center of Disease Control and the tests for Leptospira, Rickettsia typhi and Coxiella burnetii were all negative. This case indicates that scrub typhus needs to be included in the differential diagnoses of cases of bilateral and simultaneous facial nerve palsy, particularly in areas where the disease is endemic.

Tài liệu tham khảo

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The Kaohsiung Journal of Medical Sciences

Tập 27

573-576

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