Bilateral Facial Nerve Palsy in a Patient With Leptospirosis From Panama

Leptospirosis is a zoonotic tropical disease with worldwide distribution caused by bacteria from the genus Leptospira. The clinical picture is assorted, from asymptomatic subclinical disease to more severe forms affecting several organs, including lungs, liver, and kidneys. Neurologic manifestations account for 10%-20% of the cases. The most common neurological presentation is aseptic meningitis, but other syndromes, such as cranial nerve palsies, and encephalitis, are also seen. To our knowledge, this is the first reported case of this type of neurological presentation of leptospirosis in Panama. We present an unusual manifestation of leptospirosis in a 43-year-old man from Panama City who presented with constitutional symptoms and developed bilateral facial palsy and liver involvement during his hospitalization.