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眼阵挛:恙虫病感染患者中一种罕见的神经学表现。

Opsoclonus: A Rare Neurological Manifestation in a Patient With Scrub Typhus Infection.

作者信息

Neela Akhil, Gohil Rucha, Tagore Ravindra, Ta Vidya

机构信息

General Medicine, SRM Medical College Hospital and Research Centre, Chengalpattu, IND.

出版信息

Cureus. 2024 Sep 23;16(9):e70058. doi: 10.7759/cureus.70058. eCollection 2024 Sep.

Abstract

Scrub typhus, prevalent in tropical regions, exhibits a wide range of symptoms, from non-specific signs to severe conditions such as pneumonia, gastroenteritis, lymphadenitis, meningitis, encephalitis, acute kidney injury, and multi-organ dysfunction syndrome. Neurological symptoms like opsoclonus are rarely seen. This report details an unusual case of a 34-year-old male who first complained of high temperature, headache, and sore muscles. Initially treated with antipyretics and oral antibiotics, his symptoms persisted and new ones emerged, leading to an emergency visit with complaints of blurred vision. Upon confirming scrub typhus with opsoclonus, appropriate antibiotics were administered. Persistent fever and opsoclonus prompted suspicion of an atypical infection. A detailed history and investigations, including IgM testing against the scrub typhus antigen, confirmed the diagnosis. Treatment with doxycycline resulted in significant symptom improvement, leading to discharge. This case underscores the need to consider atypical organisms in neurological symptoms, which can be effectively treated with timely diagnosis.

摘要

恙虫病在热带地区流行,症状范围广泛,从非特异性体征到严重病症,如肺炎、肠胃炎、淋巴结炎、脑膜炎、脑炎、急性肾损伤和多器官功能障碍综合征。像眼阵挛这样的神经症状很少见。本报告详细介绍了一例不寻常的病例,一名34岁男性最初抱怨发热、头痛和肌肉酸痛。最初用退烧药和口服抗生素治疗,其症状持续并出现新症状,导致因视力模糊前来急诊。在确诊为伴有眼阵挛的恙虫病后,给予了适当的抗生素。持续发热和眼阵挛引发了对非典型感染的怀疑。详细的病史和检查,包括针对恙虫病抗原的IgM检测,证实了诊断。用多西环素治疗使症状显著改善,随后出院。该病例强调了在出现神经症状时需考虑非典型病原体,及时诊断可有效治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/750f/11499894/7592259308a6/cureus-0016-00000070058-i01.jpg

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