Motor and sensory polyneuritis with distal conduction failure as uncommon complication of an acute Rickettsia conorii infection.
Rickettsia conorii is endemic in the Mediterranean region. Infections are mostly benign and neurological involvement is unusual. We describe a case of a man who presented with acute facial nerve palsy followed by flaccid tetraparesis due to an electrophysiologically established polyneuritis with distal conduction failure. Elevated IgM antibody titres for R. conorii were documented by indirect immunofluorescent antibody test. After doxycycline therapy, the patient presented a rapid clinical improvement. Repeated electrophysiological examinations revealed significantly restored compound muscles, and sensory action potentials, corresponding to the clinical course after treatment and ex juvantibus, indicate the causative relation between R. conorii infection and the described clinical syndrome.
Spengos
Konstantinos
K
Department of Neurology, University of Athens Medical School, Athens, Greece. spengos@hol.gr
Stouraitis
Georgios
G
Voumvourakis
Konstantinos
K
Zambelis
Thomas
T
Karandreas
Nikolaos
N
D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000907:Antibodies, Bacterial / Q000302:isolation & purification; D004318:Doxycycline / Q000627:therapeutic use; D019054:Evoked Potentials, Motor / Q000187:drug effects / Q000502:physiology*; D005073:Evoked Potentials, Somatosensory / Q000187:drug effects / Q000502:physiology; D006801:Humans; D007075:Immunoglobulin M / Q000378:metabolism; D008297:Male; D009431:Neural Conduction / Q000187:drug effects / Q000502:physiology*; D009443:Neuritis / Q000209:etiology* / Q000382:microbiology; D012282:Rickettsia Infections / Q000150:complications* / Q000188:drug therapy / Q000276:immunology; D020114:Rickettsia conorii
D000900:Anti-Bacterial Agents; D000907:Antibodies, Bacterial; D007075:Immunoglobulin M; D004318:Doxycycline