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Ophthalmoplegia Due to Scrub Typhus
Jinhyun Kim1, Ji Seon Kim, Dong-Ik Shin
1Department of Neurology (JK, JSK, D-IS, S-HL, S-SL), Chungbuk National University College Medicine, Chungbuk National University Hospital, Cheoungju, Korea; and Department of Neurology (S-YC), Eulji University Hospital, Daejeon, Korea.
Summary
Scrub typhus, an infectious disease, can cause neurological issues like ptosis and ophthalmoplegia. Early diagnosis and doxycycline treatment led to the resolution of these severe symptoms in a reported case.
Area of Science:
- Infectious Diseases
- Neurology
- Ophthalmology
Background:
- Scrub typhus is an acute febrile illness caused by Orientia tsutsugamushi.
- The disease typically presents with fever, rash, and lymphadenopathy.
- Severe cases may involve pulmonary and neurological complications.
Observation:
- A 69-year-old male presented with ptosis and ophthalmoplegia.
- Magnetic resonance imaging revealed a focal nodular lesion in the anterior cavernous sinus.
- The patient was diagnosed with scrub typhus.
Findings:
- The ptosis and ophthalmoplegia symptoms were directly linked to scrub typhus infection.
- Treatment with doxycycline was initiated for the scrub typhus.
- Complete resolution of ptosis and ophthalmoplegia was observed post-treatment.
Implications:
- This case highlights scrub typhus as a potential cause of isolated cranial nerve palsies.
- Early recognition and prompt antibiotic therapy are crucial for managing neurological manifestations of scrub typhus.
- Ophthalmoplegia and ptosis can be reversible complications of scrub typhus with appropriate treatment.
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