Murine Typhus with Presentation of Unilateral Abducens Nerve Palsy: A Case Report

地方性斑疹傷寒合併單側外旋神經麻痺：病例報告

許哲翰(Che-Han Hsu) ； 謝良博(Liang-Po Hsieh)

《內科學誌》 25卷1期 (2014/01) Pp. 36-40

https://doi.org/10.6314/JIMT.2014.25(1).07

摘要

斑疹傷寒合併神經學併發症並不常見，若併發外旋神經麻痺更是罕見。我們報告一例31歲男性病患在巴里島感染斑疹傷寒併發顱內壓升高與單側外旋神經麻痺的個案。病患在腰椎穿刺後不到12小時出現右側外旋神經麻痺。經過單用適當抗生素治療後，病患恢復良好。外旋神經麻痺3個月後完全緩解。

並列摘要

Neurologic complications of murine typhus were uncommon but included aseptic meningitis, meningoencephalitis and rarely if ever, cranial nerve deficit. We report a rare case of murine typhus complicated with increased intracranial pressure and isolated abducens nerve palsy in a 31-year-old returned traveler. The patient developed right abducens nerve palsy in the absence of other neurologic symptoms or signs within 12 hours following receipt of a lumbar puncture. Murine typhus was diagnosed by serology using indirect immunofluorescence assay. The patient received 8-day antibiotic therapy with favorable response. His abducens palsy resolved completely without adjuvant therapy in 3 months. Literature was reviewed focusing on pathogenesis and management. (J Intern Med Taiwan 2014; 25: 36-40)

並列關鍵字

Murine typhus ； Neurologic complications ； Abducens nerve palsy