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Related Concept Videos

Types of Fever01:25

Types of Fever

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Fever can be triggered by several factors, including infections, nervous system disorders, certain cancers, blood diseases like leukemia, embolism, thrombosis, heatstroke, dehydration, surgical trauma, crushing injuries, and allergic reactions.
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Patterns of Fever01:26

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Lateralization01:28

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The lateral view of the cranium is dominated by temporal, sphenoid, and ethmoid bones.
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Left heart catheterization is an invasive diagnostic procedure used to evaluate the function and structure of the left side of the heart. It is generally performed to diagnose and treat cardiovascular conditions such as valve abnormalities, coronary artery disease, and congenital heart defects.Diagnostic and therapeutic purposesLeft heart catheterization serves various diagnostic and therapeutic purposes, including:Assessing coronary artery bypass grafts.Evaluating coronary artery disease in...
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Author Spotlight: Exploring the Potential of Massage Therapy in Cerebral Palsy Using Animal Models
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Typhoid fever with isolated left lateral rectus palsy.

Abishkar Thapa1, Nancy Mittal1, Gyan Kayastha2

  • 1Oxford University Clinical Research Unit, Patan Hospital, Lalitpur, Province - 3, Nepal.

BMJ Case Reports
|September 6, 2018
PubMed
Summary

A young woman with enteric fever developed temporary double vision due to left lateral rectus palsy. Steroid treatment resolved the diplopia, suggesting a vasculitic cause.

Keywords:
cranial nervesinfection (gastroenterology)neuroopthalmologytropical medicine (infectious disease)

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Area of Science:

  • Neurology
  • Infectious Diseases
  • Ophthalmology

Background:

  • Enteric fever, caused by Salmonella Typhi, is a systemic infection prevalent in South Asia.
  • Neurological complications of enteric fever, though rare, can significantly impact patient outcomes.

Observation:

  • A 17-year-old female presented with symptoms suggestive of enteric fever, including fever, headache, and vomiting.
  • Following initial treatment with azithromycin, the patient developed new-onset diplopia (double vision).
  • Clinical examination revealed isolated left lateral rectus palsy as the cause of diplopia.

Findings:

  • Blood culture confirmed Salmonella Typhi infection.
  • The patient's diplopia resolved after a course of methylprednisolone, indicating a potential inflammatory or vasculitic process.
  • The left lateral rectus palsy was hypothesized to result from vasculitic changes affecting the abducens nerve.

Implications:

  • This case highlights a rare neurological complication of enteric fever, specifically abducens nerve palsy.
  • Early recognition and management of such complications are crucial for preventing long-term sequelae.
  • The findings suggest a potential role for anti-inflammatory treatment in managing neuro-ophthalmic manifestations of enteric fever.