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Bilateral simultaneous facial palsy following scrub typhus meningitis: a case report and literature review.
Kaohsiung J Med Sci. 2011 Dec; 27(12):573-6.KJ

Abstract

Scrub typhus is widely distributed across the Asia-Pacific region, Taiwan included. The clinical manifestations and complications of scrub typhus vary and the illness ranges in severity from mild to fatal. The etiology of facial nerve palsy varies and infectious agents have been associated with this condition. Rickettsiae species have, however, rarely been reported as the causative agents. We report the case of a 49-year-old man who had fever, malaise, headache, oligouria and tea-colored urine. Bilateral pneumonitis, acute renal failure, acalculous cholecystitis and aseptic meningitis were diagnosed after a series of examinations. The patient recovered after doxycycline treatment but he developed bilateral facial palsy during the convalescent phase, which improved after the administration of a steroid. The diagnosis of infection with Orientia tsutsugamushi was confirmed by the Taiwan Center of Disease Control and the tests for Leptospira, Rickettsia typhi and Coxiella burnetii were all negative. This case indicates that scrub typhus needs to be included in the differential diagnoses of cases of bilateral and simultaneous facial nerve palsy, particularly in areas where the disease is endemic.

Authors+Show Affiliations

Division of Infectious Diseases, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Case Reports
Journal Article
Review

Language

eng

PubMed ID

22208541

Citation

Lin, Wei-Ru, et al. "Bilateral Simultaneous Facial Palsy Following Scrub Typhus Meningitis: a Case Report and Literature Review." The Kaohsiung Journal of Medical Sciences, vol. 27, no. 12, 2011, pp. 573-6.
Lin WR, Chen TC, Lin CY, et al. Bilateral simultaneous facial palsy following scrub typhus meningitis: a case report and literature review. Kaohsiung J Med Sci. 2011;27(12):573-6.
Lin, W. R., Chen, T. C., Lin, C. Y., Lu, P. L., & Chen, Y. H. (2011). Bilateral simultaneous facial palsy following scrub typhus meningitis: a case report and literature review. The Kaohsiung Journal of Medical Sciences, 27(12), 573-6. https://doi.org/10.1016/j.kjms.2011.10.003
Lin WR, et al. Bilateral Simultaneous Facial Palsy Following Scrub Typhus Meningitis: a Case Report and Literature Review. Kaohsiung J Med Sci. 2011;27(12):573-6. PubMed PMID: 22208541.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Bilateral simultaneous facial palsy following scrub typhus meningitis: a case report and literature review. AU - Lin,Wei-Ru, AU - Chen,Tun-Chieh, AU - Lin,Chun-Yu, AU - Lu,Po-Liang, AU - Chen,Yen-Hsu, Y1 - 2011/11/25/ PY - 2010/11/01/received PY - 2011/01/05/accepted PY - 2012/1/3/entrez PY - 2012/1/3/pubmed PY - 2012/4/24/medline SP - 573 EP - 6 JF - The Kaohsiung journal of medical sciences JO - Kaohsiung J Med Sci VL - 27 IS - 12 N2 - Scrub typhus is widely distributed across the Asia-Pacific region, Taiwan included. The clinical manifestations and complications of scrub typhus vary and the illness ranges in severity from mild to fatal. The etiology of facial nerve palsy varies and infectious agents have been associated with this condition. Rickettsiae species have, however, rarely been reported as the causative agents. We report the case of a 49-year-old man who had fever, malaise, headache, oligouria and tea-colored urine. Bilateral pneumonitis, acute renal failure, acalculous cholecystitis and aseptic meningitis were diagnosed after a series of examinations. The patient recovered after doxycycline treatment but he developed bilateral facial palsy during the convalescent phase, which improved after the administration of a steroid. The diagnosis of infection with Orientia tsutsugamushi was confirmed by the Taiwan Center of Disease Control and the tests for Leptospira, Rickettsia typhi and Coxiella burnetii were all negative. This case indicates that scrub typhus needs to be included in the differential diagnoses of cases of bilateral and simultaneous facial nerve palsy, particularly in areas where the disease is endemic. SN - 2410-8650 UR - https://www.unboundmedicine.com/medline/citation/22208541/Bilateral_simultaneous_facial_palsy_following_scrub_typhus_meningitis:_a_case_report_and_literature_review_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1607-551X(11)00226-9 DB - PRIME DP - Unbound Medicine ER -