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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...

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Autores principales: Jamil, M. D., Hussain, Masaraf, Lyngdoh, Monaliza, Sharma, Shriram, Barman, Bhupen, Bhattacharya, P. K.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Medknow Publications & Media Pvt Ltd 2015
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.
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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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