Intra-aural tick bite causing unilateral facial nerve palsy in 29 cases over 16 years in Kandy, Sri Lanka: is rickettsial aetiology possible?
| Autor: | Sinnadurai Selvaratnam, Chandrasiri Narampanawa, Sujanthe Wickramasinghe, Kosala Weerakoon, Vajira S. Weerasinghe, Manoji Pathirage, Senanayake A. M. Kularatne, Ranjan Fernando, Anura T. Bandara, Jayanthe Rajapakse |
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| Jazyk: | angličtina |
| Rok vydání: | 2018 |
| Předmět: |
Male
Tick infestation Tick bite Otoacariasis 0302 clinical medicine Ticks Rickettsial 030212 general & internal medicine Rickettsia Palsy biology Amblyomma Middle Aged Antibodies Bacterial Anti-Bacterial Agents Rhipicephalus Infectious Diseases Treatment Outcome Doxycycline Female Dermacentor Ear Canal Research Article Adult DNA Bacterial medicine.medical_specialty 030231 tropical medicine Facial Paralysis Tick lcsh:Infectious and parasitic diseases 03 medical and health sciences Young Adult parasitic diseases medicine Animals Humans lcsh:RC109-216 Sri Lanka Aged Retrospective Studies Tick Bites business.industry Rickettsia Infections medicine.disease biology.organism_classification Dermatology Spotted fever Facial nerve palsy Etiology business |
| Zdroj: | BMC Infectious Diseases BMC Infectious Diseases, Vol 18, Iss 1, Pp 1-9 (2018) |
| ISSN: | 1471-2334 |
| Popis: | Background Over the last two decades intra-aural tick infestation (otoacariasis) has been a common occurrence in the hilly central region in Sri Lanka. Very occasional detection of isolated unilateral facial nerve palsy associated with otoacariasis attributed to toxin damage of the nerve prompted us to study the clinico-epidemiology and aetio-pathology of the problem. Methods All cases having isolated unilateral facial nerve palsy associated with otoacariasis presented to, Ear Nose and Throat clinic at General Hospital Kandy, Sri Lanka from 2001 to 2016 were included in the study. The facial palsies were assessed with nerve conduction studies and, harvested ticks were identified. Results There were 29 patients with mean age of 46 years (range 22–76 years) with male to female ratio of 1:1.9. First 12 patients without specific treatment took 1–55 months for recovery and 4 had axonal degeneration. Last 5 patients were treated with doxycycline and recovered in 4 weeks. They had strong sero-conversion of immunofluorescence antibodies against spotted fever rickettsioses and the tick harvested from the last patient was PCR positive for rickettsial DNA. Identified ticks belonged to Dermacentor, Amblyomma, Rhipicephalus and Hyalomma species. Conclusions On contrary to popular toxin theory, we were able to demonstrate treatable rickettsial aetio-pathology as the cause of otoacariasis associated lower motor facial palsy in Sri Lanka. |
| Databáze: | OpenAIRE |
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