title: Legionellosis presenting as singultus and external ophthalmoplegia.
abstract: We report a 71-year-old man with legionellosis, who presented with abducens nerve palsy, singultus, confusion, memory impairment, ataxia, and hyporeflexia. Legionella pneumonia was diagnosed on the basis of detection of Legionella pneumophila antigen in the urine. The cerebrospinal fluid was negative for the antigen and antibody, but an oligoclonal band was detected, and the IgG index was elevated. It was speculated that an undetermined immune-mediated mechanism had contributed to the development of the neurological manifestations.
authors.affiliation: Division of Neurology, Department of Internal Medicine, Toho University Ohashi Medical Center, 2-17-6 Ohashi, Tokyo, 153-8515, Japan. d500372@oha.toho-u.ac.jp
authors.forename: Shingo
authors.initials: S
authors.lastname: Konno
authors.forename: Haruhi
authors.initials: H
authors.lastname: Kono
authors.forename: Hisao
authors.initials: H
authors.lastname: Kitazono
authors.forename: Mayumi
authors.initials: M
authors.lastname: Murata
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Nakazora
authors.forename: Nobuatsu
authors.initials: N
authors.lastname: Nomoto
authors.forename: Hideki
authors.initials: H
authors.lastname: Sugimoto
authors.forename: Ken
authors.initials: K
authors.lastname: Sanno
authors.forename: Toshiki
authors.initials: T
authors.lastname: Fujioka
mesh_terms: D000368:Aged; D003937:Diagnosis, Differential; D006801:Humans; D007876:Legionellosis / Q000150:complications* / Q000175:diagnosis*; D008171:Lung Diseases / Q000150:complications / Q000175:diagnosis; D008297:Male; D009886:Ophthalmoplegia / Q000150:complications* / Q000175:diagnosis*