Abducens nerve palsy with associated retinal involvement secondary to rickettsia typhi infection

Abstract Objective To report a case of abducens nerve palsy with associated retinal involvement due to rickettsia typhi infection. Material and methods A single documented multimodal imaging. Results 18-year-old woman history high-grade fever was initially diagnosed typhoid treated fluoroquinolone. She presented 5-day diplopia headaches. Her best-corrected visual acuity 20/20 in both eyes. Ocular motility examination showed left lateral gaze restriction. Lancaster test confirmed the presence palsy. Fundus optic disc swelling eyes superotemporal hemorrhage small infiltrate nasal periphery eye. Magnetic resonance imaging (MRI) brain orbits no abnormalities. diagnosis rickettsial disease suspected serologic for Richettsia Typhi positive. The patient doxycycline (100 mg every 12 h) 15 days complete recovery rectus resolution swelling, hemorrhages, infiltrate. Conclusion Rickettsial should be considered differential any unexplained from endemic area. may help establish an early start appropriate treatment.