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钩端螺旋体病一例中的周围神经麻痹

Peripheral nerve palsy in a case of leptospirosis.

作者信息

de Souza Alexandre Leite, Sztajnbok Jaques, Spichler Anne, Carvalho Solyon Maia, de Oliveira Augusto César Penalva, Seguro Antonio Carlos

机构信息

Emílio Ribas Institute of Infectology, Av. Dr. Arnaldo 165, CEP 01246-000, São Paulo, Brazil.

出版信息

Trans R Soc Trop Med Hyg. 2006 Jul;100(7):701-3. doi: 10.1016/j.trstmh.2005.10.012. Epub 2006 Feb 17.

Abstract

We describe an unusual case of leptospirosis in a 54-year-old man presenting peripheral nerve palsy. The diagnosis of leptospirosis was confirmed by ELISA IgM and the microscopic agglutination test. Electrophysiological studies showed that no response could be obtained from the right fibular nerve. At 7 months after the initiation of treatment, additional electrophysiological studies and a neurological examination showed, respectively, a chronic axonal lesion of right fibular nerve with signs of re-innervation and a nearly complete clinical recovery. We feel that this case may serve to remind clinicians that peripheral nerve palsy is a potential clinical feature of leptospirosis.

摘要

我们描述了一例54岁男性患钩端螺旋体病并伴有周围神经麻痹的罕见病例。通过ELISA IgM和显微镜凝集试验确诊为钩端螺旋体病。电生理研究显示右侧腓总神经无反应。治疗开始7个月后,进一步的电生理研究和神经学检查分别显示右侧腓总神经存在慢性轴索性损伤并有再支配迹象,且临床几乎完全恢复。我们认为该病例可能有助于提醒临床医生,周围神经麻痹是钩端螺旋体病的一个潜在临床特征。

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