Cranial Nerve Palsy and Diplopia in Typhoid Fever: Case Report
Abstract
Salmonella typhi is the cause of an acute febrile illness with high morbidity and mortality, especially in countries with poor sanitation. Neurological complications of salmonella are severe and usually under-diagnosed. This article reports an extremely rare case of a woman with typhoid fever with a history of travel and consumption of raw fish. She had no sign of meningitis but developed diplopia and sixth nerve palsy, which was ultimately resolved by antibiotic therapy.
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17. Lutterloh E, Likaka A, Sejvar J, Manda R, Naiene J, Monroe SS, et al. Multidrug-resistant typhoid fever with neurologic findings on the Malawi-Mozambique border. Clinical infectious diseases : an official publication of the Infectious Diseases Society of
18. Gkrania-Klotsas E, Cooke FJ, Zochios V, Lofitou N. Fever, a blue hand, and abducens nerve paralysis in a returning traveler. Journal of travel medicine. 2009;16(1):57-9. https://doi.org/10.1111/j.1708-8305.2008.00262.x
19. Bhatt GC, Dewan V, Dewan T, Yadav TP. Pseudotumour cerebri with multiple cranial nerve palsies in enteric fever. Indian jour- nal of pediatrics. 2014;81(2):196-7. https://doi.org/10.1007/ s12098-013-0965-3
20. Joshi N, Bhattacharya M, Yadav S, Rustogi D. Cranial nerve palsies in typhoid fever: report of three cases. Annals of tropical paediatrics. 2011;31(3):255-8. https://doi.org/10.117 9/1465328111Y.0000000023
2. Dougan G, Baker S. Salmonella enterica serovar Typhi and the pathogenesis of typhoid fever. Annual review of microbi- ology. 2014;68:317-36. https://doi.org/10.1146/annurev-mi- cro-091313-103739
3. Darton TC, Blohmke CJ, Pollard AJ. Typhoid epidemiology, diagnostics and the human challenge model. Current opinion in gastroenterology. 2014;30(1):7-17. https://doi.org/10.1097/MOG.0000000000000021
4. Crump JA, Sjölund-Karlsson M, Gordon MA, Parry CM. Epidemi- ology, Clinical Presentation, Laboratory Diagnosis, Antimicrobial Resistance, and Salmonel- la Infections. Clinical Microbiology Reviews. 2015;28(4):901-37. https://doi.org/10.1128/CMR.00002-15
5. Connor BA, Schwartz E. Typhoid and paratyphoid fever in travellers. The Lancet Infectious diseases. 2005;5(10):623-8. https://doi.org/10.1016/S1473-3099(05)70239-5
6. Ostergaard L, Huniche B, Andersen PL. Relative bradycardia in infectious diseases. The Journal of infection. 1996;33(3):185-91. https://doi.org/10.1016/S0163-4453(96)92225-2
7. Parry CM, Hien TT, Dougan G, White NJ, Farrar JJ. Typhoid Fever. New England Journal of Medicine. 2002;347(22):1770-82. https://doi.org/10.1056/NEJMra020201
8. Scaggs Huang FA, Schlaudecker E. Fever in the Returning Traveler. Infectious Disease Clinics of North America. 2018;32(1):163-88. https://doi.org/10.1016/j.idc.2017.10.009
9. Stuart BM, Pullen RL. Typhoid; clinical analysis of 360 cases. Ar- chives of internal medicine (Chicago, Ill : 1908). 1946;78(6):629- 61.https://doi.org/10.1001/archinte.1946.00220060002001
10. Hoffman SL, Punjabi NH, Kumala S, Moechtar MA, Pulungsih SP, Rivai AR, et al. Reduction of mortality in chloramphenicol- treated severe typhoid fever by high-dose dexamethasone. The New England journal of medicine. 1984;310(2):82-8. https://doi.org/10.1056/NEJM198401123100203
11. El-Newihi HM, Alamy ME, Reynolds TB. Salmonella hepatitis: analysis of 27 cases and comparison with acute viral hepatitis. Hepatology (Baltimore, Md). 1996;24(3):516-9. https://doi.org/10.1002/hep.510240308
12. Khan FY, Kamha AA, Alomary IY. Fulminant hepatic failure caused by Salmonella paratyphi A infection. World J Gastroenterol. 2006;12(32):5253-5.
13. Andrews JR, Ryan ET. Diagnostics for invasive Salmonella infections: current challenges and future directions. Vac- cine. 2015;33(0 3):C8-C15. https://doi.org/10.1016/j.vac- cine.2015.02.030
14. MacFadden DR, Bogoch, II, Andrews JR. Advances in diagnosis, treatment, and prevention of invasive Salmonella infections. Current opinion in infectious diseases. 2016;29(5):453-8. https://doi.org/10.1097/QCO.0000000000000302
15. Huang DB, DuPont HL. Problem pathogens: extra-intestinal complications of Salmonella enterica serotype Typhi infection. The Lancet Infectious diseases. 2005;5(6):341-8. https://doi.org/10.1016/S1473-3099(05)70138-9
16. Lakhotia M, Gehlot RS, Jain P, Sharma S, Bhargava A. Neurological manifestations of enteric fever2003. 196-9 p.
17. Lutterloh E, Likaka A, Sejvar J, Manda R, Naiene J, Monroe SS, et al. Multidrug-resistant typhoid fever with neurologic findings on the Malawi-Mozambique border. Clinical infectious diseases : an official publication of the Infectious Diseases Society of
18. Gkrania-Klotsas E, Cooke FJ, Zochios V, Lofitou N. Fever, a blue hand, and abducens nerve paralysis in a returning traveler. Journal of travel medicine. 2009;16(1):57-9. https://doi.org/10.1111/j.1708-8305.2008.00262.x
19. Bhatt GC, Dewan V, Dewan T, Yadav TP. Pseudotumour cerebri with multiple cranial nerve palsies in enteric fever. Indian jour- nal of pediatrics. 2014;81(2):196-7. https://doi.org/10.1007/ s12098-013-0965-3
20. Joshi N, Bhattacharya M, Yadav S, Rustogi D. Cranial nerve palsies in typhoid fever: report of three cases. Annals of tropical paediatrics. 2011;31(3):255-8. https://doi.org/10.117 9/1465328111Y.0000000023
| Files | ||
| Issue | Vol 7 No 4 (2022): July-August | |
| Section | Case Report(s) | |
| DOI | https://doi.org/10.18502/crcp.v7i4.11601 | |
| Keywords | ||
| Salmonella typhi Diplopia Abducens nerve Typhoid fever | ||
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How to Cite
1.
Taslimi R, Bayat T, Pazooki B, Nabipoorashrafi SA. Cranial Nerve Palsy and Diplopia in Typhoid Fever: Case Report. CRCP. 2023;7(4):211-215.
