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Rickettsial fever presenting with isolated third nerve palsy

Anjali Rajadhyaksha1, Sanat Phatak1, Nilesh Nolkha1

  • 1Department of Medicine, Seth GS Medical College and KEM Hospital, Mumbai.

The Journal of the Association of Physicians of India
|January 30, 2014
PubMed

Insights

Rickettsial infections can cause neurological issues. This case highlights a rare instance of third cranial nerve palsy in a young man due to rickettsia, successfully treated with doxycycline.

Area of Science:

  • Neurology
  • Infectious Diseases
  • Ophthalmology

Background:

  • Rickettsial fevers frequently manifest with central nervous system involvement, primarily meningoencephalitis.
  • Focal neurological deficits, such as isolated cranial nerve palsies, are uncommon presentations of rickettsial infections.

Observation:

  • A 25-year-old male presented with high-grade fever attributed to a rickettsial infection.
  • The patient exhibited a left-sided partial third cranial nerve palsy.

Findings:

  • The clinical presentation included fever and a specific cranial nerve deficit.
  • Diagnosis was confirmed as rickettsial fever with associated third nerve palsy.

Implications:

  • This case expands the spectrum of neurological complications associated with rickettsial infections.
  • Highlights the importance of considering rickettsial etiologies in patients with fever and cranial nerve palsies.
  • Doxycycline demonstrates efficacy in treating rickettsial infections with neurological sequelae.

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