DR. ROOPA ROKHADE

Abstract

Rickettsial Infections are re-emerging and have become endemic in many parts of India. Ocular manifestations mainly involve posterior segment findings like retinitis, retinal vasculitis and optic disc changes. Neurological manifestation in the form of meningoencephalitis is known to happen, but isolated involvement of the cranial nerve is rare. Here we have reported a rare case of incomplete third nerve palsy with pupil involvement in a patient with rickettsial fever. MRI brain and orbits with angiography was normal. Patient responded dramatically to Doxycycline, which is the drug of choice for rickettsial fever. His third nerve palsy showed improvement during follow up three weeks later. This case highlights the importance of including rickettsial fever as one of the differential diagnoses in patients presenting with fever, rashes, and third nerve palsy in endemic areas.