Miller Fisher syndrome is characterised by ataxia, areflexia, and ophthalmoplegia and was first described by Charles Miller Fisher in 1956 as an unusual variant of acute idiopathic polyneuritis. There is frequently an antecedent illness¹ and the syndrome is associated with a high titre of anti-GQ1b antibodies in approximately 90% of cases.^1,2Pasteurella multocida is a Gram negative bacteria, commonly found in the saliva of animals, particularly cats.³

We present the case of a 70 year old lady who developed Miller Fisher syndrome with positive anti-GQ1b antibodies 11 days after P. multocida was cultured from a blood sample. Miller Fisher syndrome associated with P. multocida infection has not, to our knowledge, been described previously.

Case report

A 70 year old lady presented with a one day history of a painful left hip, fever, sweats, and lethargy following a bite from her pet cat on her left leg on the preceding day. She reported no other recent illnesses. She had had a total left hip replacement four years previously. On examination she was hypotensive and pyrexial with local tenderness …