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Meningeal Signs and Cerebellar Involvement in Scrub Typhus: A Case Report

Scrub typhus is an arthropod-borne fever that follows the bite of the larval form of Leptotrombidium mite carrying Orientia tsutsugamushi. It remains a serious health problem in the Asia-Pacific region. While it commonly presents as an undifferentiated fever with chills and an eschar, complications...

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Autores principales: Bhandari, Sadikshya, Bhandari, Samikshya, Gautam, Kushal, Jha, Roshan, Devkota, Sijuka
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cureus 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9270076/
https://www.ncbi.nlm.nih.gov/pubmed/35812590
http://dx.doi.org/10.7759/cureus.25708
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author Bhandari, Sadikshya
Bhandari, Samikshya
Gautam, Kushal
Jha, Roshan
Devkota, Sijuka
author_facet Bhandari, Sadikshya
Bhandari, Samikshya
Gautam, Kushal
Jha, Roshan
Devkota, Sijuka
author_sort Bhandari, Sadikshya
collection PubMed
description Scrub typhus is an arthropod-borne fever that follows the bite of the larval form of Leptotrombidium mite carrying Orientia tsutsugamushi. It remains a serious health problem in the Asia-Pacific region. While it commonly presents as an undifferentiated fever with chills and an eschar, complications like pneumonitis, acute respiratory distress syndrome, disseminated intravascular coagulation, and meningoencephalitis may cause scrub typhus to be fatal. However, regardless of the dramatic presentation, treatment with antibiotics, preferably doxycycline or even azithromycin, is effective in recovery.  In this case report, we present a case of meningitis and cerebellar involvement in an adolescent with positive scrub typhus serology in the absence of an eschar. This brought forward a diagnostic delay as other infections including tuberculosis were considered before scrub typhus due to unusual presenting symptoms and the lack of an eschar. Thus, in cases like these, it becomes imperative to be aware of the unusual manifestations to initiate antibiotics on time and prevent further complications.
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spelling pubmed-92700762022-07-09 Meningeal Signs and Cerebellar Involvement in Scrub Typhus: A Case Report Bhandari, Sadikshya Bhandari, Samikshya Gautam, Kushal Jha, Roshan Devkota, Sijuka Cureus Internal Medicine Scrub typhus is an arthropod-borne fever that follows the bite of the larval form of Leptotrombidium mite carrying Orientia tsutsugamushi. It remains a serious health problem in the Asia-Pacific region. While it commonly presents as an undifferentiated fever with chills and an eschar, complications like pneumonitis, acute respiratory distress syndrome, disseminated intravascular coagulation, and meningoencephalitis may cause scrub typhus to be fatal. However, regardless of the dramatic presentation, treatment with antibiotics, preferably doxycycline or even azithromycin, is effective in recovery.  In this case report, we present a case of meningitis and cerebellar involvement in an adolescent with positive scrub typhus serology in the absence of an eschar. This brought forward a diagnostic delay as other infections including tuberculosis were considered before scrub typhus due to unusual presenting symptoms and the lack of an eschar. Thus, in cases like these, it becomes imperative to be aware of the unusual manifestations to initiate antibiotics on time and prevent further complications. Cureus 2022-06-07 /pmc/articles/PMC9270076/ /pubmed/35812590 http://dx.doi.org/10.7759/cureus.25708 Text en Copyright © 2022, Bhandari et al. https://creativecommons.org/licenses/by/3.0/This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Internal Medicine
Bhandari, Sadikshya
Bhandari, Samikshya
Gautam, Kushal
Jha, Roshan
Devkota, Sijuka
Meningeal Signs and Cerebellar Involvement in Scrub Typhus: A Case Report
title Meningeal Signs and Cerebellar Involvement in Scrub Typhus: A Case Report
title_full Meningeal Signs and Cerebellar Involvement in Scrub Typhus: A Case Report
title_fullStr Meningeal Signs and Cerebellar Involvement in Scrub Typhus: A Case Report
title_full_unstemmed Meningeal Signs and Cerebellar Involvement in Scrub Typhus: A Case Report
title_short Meningeal Signs and Cerebellar Involvement in Scrub Typhus: A Case Report
title_sort meningeal signs and cerebellar involvement in scrub typhus: a case report
topic Internal Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9270076/
https://www.ncbi.nlm.nih.gov/pubmed/35812590
http://dx.doi.org/10.7759/cureus.25708
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