Bilateral abducens nerve palsy in anicteric leptospirosis: A case report

Abstract

Rationale: Neuroleptospirosis is an uncommon manifestation of leptospirosis. Cranial nerve involvement is extremely rare.

Patient concerns: A 17-year-old girl presented with fever, myalgia, and mild transaminitis. Her serology was positive for Leptospira in the second week of illness. During her hospital stay she developed bilateral 6th nerve palsy.

Diagnosis: Rare manifestation of neuroleptospirosis presenting as bilateral abducens nerve palsy.

Interventions: Antibiotics, cerebrospinal fluid analysis, retinal examination and careful monitoring.

Outcomes: She recovered without any residual neurological deficit.

Lessons: Patients suffering from acute febrile illness with cranial nerve palsy in tropical and subtropical regions may have central nervous system involvement due to pathogenic leptospires (i.e., neuroleptospirosis). Early suspicion, careful monitoring, and timely intervention are required.

Keywords

Leptospirosis / Neglected tropical disease / Neurological involvement / Abducens nerve palsy

References

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