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Scrub typhus meningoencephalitis, a diagnostic challenge for clinicians: A hospital based study from North-East India
Central nervous system (CNS) involvement is a known complication of scrub typhus which range from mild meningitis to frank meninigoencephalitis. AIMS AND OBJECTIVES: To study the clinical feature, laboratory parameters and response to treatment of scrub typhus meningitis/meningoencephalitis. METHODS...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Medknow Publications & Media Pvt Ltd
2015
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4692003/ https://www.ncbi.nlm.nih.gov/pubmed/26752890 http://dx.doi.org/10.4103/0976-3147.169769 |
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author | Jamil, M. D. Hussain, Masaraf Lyngdoh, Monaliza Sharma, Shriram Barman, Bhupen Bhattacharya, P. K. |
author_facet | Jamil, M. D. Hussain, Masaraf Lyngdoh, Monaliza Sharma, Shriram Barman, Bhupen Bhattacharya, P. K. |
author_sort | Jamil, M. D. |
collection | PubMed |
description | Central nervous system (CNS) involvement is a known complication of scrub typhus which range from mild meningitis to frank meninigoencephalitis. AIMS AND OBJECTIVES: To study the clinical feature, laboratory parameters and response to treatment of scrub typhus meningitis/meningoencephalitis. METHODS AND MATERIALS: This is a hospital based prospective observational study from North Eastern India. Diagnosis was based on clinical features and positive serological test (Weil's Felix test and IgM antibody card test). RESULTS: 13 patients of scrub typhus with features of meningitis/meningoencephalitis were included. The mean duration of fever before presentation was 5.61±3.08 days and 4 (30.76 %) patients had eschar. Altered sensorium, headache, seizure and meningeal sign were present in 13 (100%), 13 (100%), 6 (46.15%) and 10 (76.92%) patients respectively. Mean CSF protein, glucose and Adenosine deaminase was 152.16±16.88mg/dl, 55.23±21.7mg/dl, and 16.98±7.37U/L respectively. Mean total count of CSF leukocyte and lymphocyte percentage was 46.07±131 cell/cumm and 98.66±3.09% respectively. Tablet doxycycline with or without injection azithromycin was used and that shows good response 15.38% of patients died and all of them had multi organ dysfunction. CONCLUSION: Meningoencephalitis is a common manifestation of scrub typhus and diagnosis requires high degree of clinical suspicion which if diagnosed early and specific treatment started, patients usually recover completely with few complications. |
format | Online Article Text |
id | pubmed-4692003 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2015 |
publisher | Medknow Publications & Media Pvt Ltd |
record_format | MEDLINE/PubMed |
spelling | pubmed-46920032016-01-08 Scrub typhus meningoencephalitis, a diagnostic challenge for clinicians: A hospital based study from North-East India Jamil, M. D. Hussain, Masaraf Lyngdoh, Monaliza Sharma, Shriram Barman, Bhupen Bhattacharya, P. K. J Neurosci Rural Pract Original Article Central nervous system (CNS) involvement is a known complication of scrub typhus which range from mild meningitis to frank meninigoencephalitis. AIMS AND OBJECTIVES: To study the clinical feature, laboratory parameters and response to treatment of scrub typhus meningitis/meningoencephalitis. METHODS AND MATERIALS: This is a hospital based prospective observational study from North Eastern India. Diagnosis was based on clinical features and positive serological test (Weil's Felix test and IgM antibody card test). RESULTS: 13 patients of scrub typhus with features of meningitis/meningoencephalitis were included. The mean duration of fever before presentation was 5.61±3.08 days and 4 (30.76 %) patients had eschar. Altered sensorium, headache, seizure and meningeal sign were present in 13 (100%), 13 (100%), 6 (46.15%) and 10 (76.92%) patients respectively. Mean CSF protein, glucose and Adenosine deaminase was 152.16±16.88mg/dl, 55.23±21.7mg/dl, and 16.98±7.37U/L respectively. Mean total count of CSF leukocyte and lymphocyte percentage was 46.07±131 cell/cumm and 98.66±3.09% respectively. Tablet doxycycline with or without injection azithromycin was used and that shows good response 15.38% of patients died and all of them had multi organ dysfunction. CONCLUSION: Meningoencephalitis is a common manifestation of scrub typhus and diagnosis requires high degree of clinical suspicion which if diagnosed early and specific treatment started, patients usually recover completely with few complications. Medknow Publications & Media Pvt Ltd 2015 /pmc/articles/PMC4692003/ /pubmed/26752890 http://dx.doi.org/10.4103/0976-3147.169769 Text en Copyright: © Journal of Neurosciences in Rural Practice http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms. |
spellingShingle | Original Article Jamil, M. D. Hussain, Masaraf Lyngdoh, Monaliza Sharma, Shriram Barman, Bhupen Bhattacharya, P. K. Scrub typhus meningoencephalitis, a diagnostic challenge for clinicians: A hospital based study from North-East India |
title | Scrub typhus meningoencephalitis, a diagnostic challenge for clinicians: A hospital based study from North-East India |
title_full | Scrub typhus meningoencephalitis, a diagnostic challenge for clinicians: A hospital based study from North-East India |
title_fullStr | Scrub typhus meningoencephalitis, a diagnostic challenge for clinicians: A hospital based study from North-East India |
title_full_unstemmed | Scrub typhus meningoencephalitis, a diagnostic challenge for clinicians: A hospital based study from North-East India |
title_short | Scrub typhus meningoencephalitis, a diagnostic challenge for clinicians: A hospital based study from North-East India |
title_sort | scrub typhus meningoencephalitis, a diagnostic challenge for clinicians: a hospital based study from north-east india |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4692003/ https://www.ncbi.nlm.nih.gov/pubmed/26752890 http://dx.doi.org/10.4103/0976-3147.169769 |
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