Staphylococcus Toxin-Mediated Motor Polyneuropathy

Staphylococcus aureus infection is known to cause a variety of neurologic complications, most involving the CNS, however, rarely have cases of S. aureus affecting the peripheral nervous system been reported in literature. We report a case of S. aureus toxin-mediated motor polyneuropathy in a patient presenting with acute flaccid quadriplegia. CASE SUMMARY: A 64-year-old female with mantle cell lymphoma on oral chemotherapy with ibrutinib presents with malaise and progressive ascending bilateral lower extremity weakness. Blood cultures resulted positive for methicillin-sensitive S. aureus, and she was initiated on antibiotics. Imaging studies and laboratory workup were negative for other causes of acute flaccid quadriplegia. Patient had complete resolution of her neurologic deficits with antibiotic therapy. It was determined that the likely diagnosis was Staphylococcus toxin-mediated motor polyneuropathy. CONCLUSIONS: Staphylococcal-mediated motor polyneuropathy resulting in acute flaccid quadriplegia is a rare but treatable complication of bacteremia and should remain a diagnosis of exclusion.