Doenças Neuroinfecciosas

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Unmasking of Myasthenia Gravis by Rickettsia Meningitis

Omar Nawfal, Tarek El-Halabi, Mohammad Agha and Achraf Makki

Myasthenia gravis is a chronic autoimmune neuromuscular disease that causes weakness in the skeletal muscles, which are responsible for breathing and moving parts of the body, including the arms and legs. There is no cure for myasthenia gravis, but it is treated with medications and sometimes surgery. Here, we describe the case of a 64-year-old man who presented with a 3 day history of fever, chills, diarrhea and generalized fatigue after returning from a recent trip to India. He was initially diagnosed with traveler’s diarrhea and began receiving IV hydration and was started on oral Azithromycin. The present case was special and extremely rare, as unmasking of MG occurring only few hours after a single oral dose of azithromycin with an initial manifestation of isolated respiratory compromise in a patient with Rickettsia meningitis is the first in literature.