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Scrub Typhus Presenting as Unilateral Abducens Nerve Palsy: A Case Report.
JNMA J Nepal Med Assoc. 2022 Jun 01; 60(250):573-576.JJ

Abstract

Abducens nerve palsies associated with infectious diseases are rare. Scrub typhus is an acute, febrile, infectious illness caused by Orientia tsutsugamushi carried out by vector mite zoonosis and is highly endemic in the so-called "tsutsugamushi triangle". The organism has been reported to be capable of entering the nervous system, causing meningitis and focal neurologic abnormalities. We report a 23 years old previously healthy girl who presented with fever, pain abdomen, vomiting and classical pathognomic black eschar mark on the right proximal medial calf region. After exclusion of other common infectious causes, scrub typhus serology immunoglobulin M was positive and was diagnosed with scrub typhus associated with unilateral abducens nerve palsy which responded to doxycycline therapy. On the background of strong clinical suspicion, we underline its significance in the interpretation of the serologic testing and its role in guiding the further treatment respectively.

Keywords

abducens nerve palsy; case report; Orientia tsutsugamushi; scrub typhus; zoonoses.

Authors+Show Affiliations

Department of Internal Medicine, College of Medical Sciences, Bharatpur, Chitwan, Nepal.Department of Internal Medicine, College of Medical Sciences, Bharatpur, Chitwan, Nepal.Department of Gastroenterology, College of Medical Sciences, Bharatpur, Chitwan, Nepal.

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

35690987

Citation

Ghimire, Bardan, et al. "Scrub Typhus Presenting as Unilateral Abducens Nerve Palsy: a Case Report." JNMA; Journal of the Nepal Medical Association, vol. 60, no. 250, 2022, pp. 573-576.
Ghimire B, Bhandari R, Dewan K. Scrub Typhus Presenting as Unilateral Abducens Nerve Palsy: A Case Report. JNMA J Nepal Med Assoc. 2022;60(250):573-576.
Ghimire, B., Bhandari, R., & Dewan, K. (2022). Scrub Typhus Presenting as Unilateral Abducens Nerve Palsy: A Case Report. JNMA; Journal of the Nepal Medical Association, 60(250), 573-576. https://doi.org/10.31729/jnma.7275
Ghimire B, Bhandari R, Dewan K. Scrub Typhus Presenting as Unilateral Abducens Nerve Palsy: a Case Report. JNMA J Nepal Med Assoc. 2022 Jun 1;60(250):573-576. PubMed PMID: 35690987.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Scrub Typhus Presenting as Unilateral Abducens Nerve Palsy: A Case Report. AU - Ghimire,Bardan, AU - Bhandari,Rajan, AU - Dewan,Khusraj, Y1 - 2022/06/01/ PY - 2022/01/03/received PY - 2022/05/30/accepted PY - 2022/6/12/entrez PY - 2022/6/13/pubmed PY - 2022/6/13/medline SP - 573 EP - 576 JF - JNMA; journal of the Nepal Medical Association JO - JNMA J Nepal Med Assoc VL - 60 IS - 250 N2 - : Abducens nerve palsies associated with infectious diseases are rare. Scrub typhus is an acute, febrile, infectious illness caused by Orientia tsutsugamushi carried out by vector mite zoonosis and is highly endemic in the so-called "tsutsugamushi triangle". The organism has been reported to be capable of entering the nervous system, causing meningitis and focal neurologic abnormalities. We report a 23 years old previously healthy girl who presented with fever, pain abdomen, vomiting and classical pathognomic black eschar mark on the right proximal medial calf region. After exclusion of other common infectious causes, scrub typhus serology immunoglobulin M was positive and was diagnosed with scrub typhus associated with unilateral abducens nerve palsy which responded to doxycycline therapy. On the background of strong clinical suspicion, we underline its significance in the interpretation of the serologic testing and its role in guiding the further treatment respectively. Keywords: abducens nerve palsy; case report; Orientia tsutsugamushi; scrub typhus; zoonoses. SN - 1815-672X UR - https://www.unboundmedicine.com/medline/citation/35690987/Scrub_Typhus_Presenting_as_Unilateral_Abducens_Nerve_Palsy:_A_Case_Report_ DB - PRIME DP - Unbound Medicine ER -