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Neurological Facets of Scrub Typhus: A Comprehensive Narrative Review.
Ann Indian Acad Neurol. 2021 Nov-Dec; 24(6):849-864.AI

Abstract

Scrub typhus is one of the most frequent causes of acute febrile illness in South and South-east Asian countries. Neurological features accompany 20% of scrub typhus infections, and may affect the central or peripheral nervous system, and sometime, may even occur in combination. Of late, its recognition among clinicians has increased with widening detection of its cutaneous hallmark, called eschar. Multiple mechanisms underlie neurological involvement, including direct invasion (meningitis, encephalitis), vasculitis (myositis) or immune-mediated mechanisms (opsoclonus, myoclonus, optic neuritis, Guillain-Barre syndrome). Despite an immunological basis for several neurological manifestations, response to doxycycline is remarkable, although immune therapy may be necessary for severe involvement. Scientific literature on scrub typhus neurology chiefly emanates from case reports, case series and small studies, and a comprehensive review is warranted to aid clinicians in recognising neurological involvement. This review aims at enriching this gap, and summarises clinical features, laboratory findings, and treatment options for various neurological facets of scrub typhus.

Authors+Show Affiliations

Department of Neurology, Neo Hospital, Noida, Uttar Pradesh, India.Department of Medicine, Christian Medical College, Vellore, Tamil Nadu, India.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

35359522

Citation

Garg, Divyani, and Abi Manesh. "Neurological Facets of Scrub Typhus: a Comprehensive Narrative Review." Annals of Indian Academy of Neurology, vol. 24, no. 6, 2021, pp. 849-864.
Garg D, Manesh A. Neurological Facets of Scrub Typhus: A Comprehensive Narrative Review. Ann Indian Acad Neurol. 2021;24(6):849-864.
Garg, D., & Manesh, A. (2021). Neurological Facets of Scrub Typhus: A Comprehensive Narrative Review. Annals of Indian Academy of Neurology, 24(6), 849-864. https://doi.org/10.4103/aian.aian_739_21
Garg D, Manesh A. Neurological Facets of Scrub Typhus: a Comprehensive Narrative Review. Ann Indian Acad Neurol. 2021 Nov-Dec;24(6):849-864. PubMed PMID: 35359522.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Neurological Facets of Scrub Typhus: A Comprehensive Narrative Review. AU - Garg,Divyani, AU - Manesh,Abi, Y1 - 2021/12/17/ PY - 2021/08/15/received PY - 2021/10/18/revised PY - 2021/10/29/accepted PY - 2022/4/1/entrez PY - 2022/4/2/pubmed PY - 2022/4/2/medline KW - Neurology KW - opsoclonus KW - orientia tsutsugamushi KW - scrub typhus KW - vasculitis SP - 849 EP - 864 JF - Annals of Indian Academy of Neurology JO - Ann Indian Acad Neurol VL - 24 IS - 6 N2 - Scrub typhus is one of the most frequent causes of acute febrile illness in South and South-east Asian countries. Neurological features accompany 20% of scrub typhus infections, and may affect the central or peripheral nervous system, and sometime, may even occur in combination. Of late, its recognition among clinicians has increased with widening detection of its cutaneous hallmark, called eschar. Multiple mechanisms underlie neurological involvement, including direct invasion (meningitis, encephalitis), vasculitis (myositis) or immune-mediated mechanisms (opsoclonus, myoclonus, optic neuritis, Guillain-Barre syndrome). Despite an immunological basis for several neurological manifestations, response to doxycycline is remarkable, although immune therapy may be necessary for severe involvement. Scientific literature on scrub typhus neurology chiefly emanates from case reports, case series and small studies, and a comprehensive review is warranted to aid clinicians in recognising neurological involvement. This review aims at enriching this gap, and summarises clinical features, laboratory findings, and treatment options for various neurological facets of scrub typhus. SN - 0972-2327 UR - https://www.unboundmedicine.com/medline/citation/35359522/Neurological_Facets_of_Scrub_Typhus:_A_Comprehensive_Narrative_Review_ DB - PRIME DP - Unbound Medicine ER -
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