1220 - Exploring Rikettsial infection (Rocky Mountain Spotted Fever), Stroke, and Baclofen Toxicity Considerations In An Individual With Schizoaffective Disorder

Friday, February 20, 2026

5:00 PM - 6:30 PM AST

Presenting Author(s)

GH

Gretchen L. Harknett, DO

MD / Resident
The Ohio State University Medical Center
Columbus, Ohio, United States
MT

Mark Tornero, MD

Physician Faculty / Professor
The Ohio State University Medical Center
New Albany, Ohio, United States

Submitter(s)

MT

Mark Tornero, MD

The Ohio State University Medical Center
New Albany, Ohio, United States

Case Diagnosis: Rikettsial infection

Case Description: This case reviews multiple diverse yet similar conditions and their interplay in a middle aged female with shizoaffective disorder, who contracted Rikettsial infection, with associated subsequent stroke, and later baclofen toxicity.   Complex cases like this need careful analysis of each individual condition separately and collectively through literature review to better understand treatment considerations involving complex care needs. She initially presented to an acute care facility with neck pain, sore throat, and skin rash so underwent a lumbar puncture and encephalitis panel. Rickettsia Rickettsii IgM and IgG titers were positive and doxycycline was initiated.   She later experienced left sided paralysis and brain imaging had bilateral embolic infarcts. Transthoracic echocardiogram was without vegetations.

Discussions: Her course was also complicated by acute respiratory failure with hypoxia, requiring intubation and tube feeds for nutrition given dysphagia.   She needed ongoing care for schizoaffective disorder, anxiety, depression and catatonia as well.   Baclofen was initiated in the acute care hospital to treat muscle tone and spasticity and she transferred to the rehab facility.   She continued to have low function with a further a decline so her conditions were carefully re-evaluated. Baclofen can also have side effects for CNS depression, respiratory issues, neuromuscular effects, cardiovascular symptoms, GI symptoms, and psychiatric symptoms, all of which this individual already has as predisposing factors from her current acute medical comorbidities and Rikettsial infection already detailed.

Conclusions: We’ll provide further literature review and education discussing these conditions individually and collectively to provide further knowledge on how to approach complex care strategies involving interdisciplinary care and monitoring for complications and treatment interventions.   This is imperative to optimize strategies to ensure the correct underlying condition is being treated accordingly as providers are also working against short rehab length of stays while trying to achieve home discharges.