Isolated right peroneal mononeuropathy after silent SARS-CoV-2 infection in a child: Case report and review of the literature

Abstract

Introduction: Peroneal neuropathy is considered as the most common mononeuropathy of the lower extremities, albeit with limited medical documentation. Risk factors include local injuries or recurrent minor trauma, surgery, weight loss, habitual leg crossing, other prolonged postures, or application of inappropriately fitted orthopedic devices that lead to uninterrupted pressure at the fibular head, intoxication, bicycle riding, prolonged anesthesia, lengthy hospitalization, other underlying neuropathies, diabetes mellitus, exposure to cold and irradiation and infection by neurotropic viruses. Case Report: We present a 4-year-old non-immunocompromised boy with an isolated right foot drop. At presentation, he had a characteristic walking that resulted from the inability to bend his right foot upward at the ankle. The foot drop developed gradually over the last week and was not accompanied by other symptoms. A careful history and appropriate serologic and imaging studies ruled out common causes of peroneal neuropathy except for SARS-CoV-2. Indeed, a high titer of specific IgG antibodies to this new coronavirus was detected, despite no history of prior immunization. Conclusion: Peroneal neuropathy may represent one of the many neurological sequelae of infection with SARS-CoV-2; physicians should be aware of this.