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

Autor: Wei-Ru Lin, Tun-Chieh Chen, Chun-Yu Lin, Po-Liang Lu, Yen-Hsu Chen
Jazyk: angličtina
Rok vydání: 2011
Předmět:
Zdroj: Kaohsiung Journal of Medical Sciences, Vol 27, Iss 12, Pp 573-576 (2011)
Druh dokumentu: article
ISSN: 1607-551X
DOI: 10.1016/j.kjms.2011.10.003
Popis: Scrub 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.
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