Acute Cerebellar Ataxia-uncommon Neurologic Manifestation of Enteric Fever

Abstract

Typhoid fever is a common cause of febrile illness, caused by Salmonella enterica serovar Typhi (S. Typhi), which employs specialized mechanisms to invade the intestinal mucosa and subsequently disseminates to the reticuloendothelial system. Neurological complications are uncommon and typically manifest during the second week of illness. Acute cerebellar ataxia, occurring as an isolated neurological manifestation of enteric fever, is particularly rare and is usually characterised by abnormalities in gait and speech. In the reported case, the diagnosis of enteric fever was confirmed through a positive blood culture. The primary clinical features included rapid onset of gait ataxia, limb ataxia, and dysarthria. Cerebellar involvement was observed during the second week of illness, with progression over one to two days. The symptoms remained stable for approximately one week, followed by gradual recovery under appropriate antibiotic treatment. These findings indicate that timely diagnosis and administration of suitable antibiotics are associated with favourable neurological recovery in patients with cerebellar complications of enteric fever.