Rickettsial fever presenting with isolated third nerve palsy

Rickettsial fevers are known to have neurological involvement, mostly in the form of meningoencephalitis. Focal neurodeficits, including isolated cranial nerve palsies have been rarely reported. We hereby report a case of a 25 year old man who presented to us with high grade fever caused by rickettsia and left sided partial third cranial nerve palsy. He responded to doxycycline.