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