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Neurological manifestations of scrub typhus: encephalitis and Guillain-Barré syndrome (GBS).
BMJ Case Rep. 2023 Mar 29; 16(3)BC

Abstract

Scrub typhus is a tropical febrile illness that mainly affects rural populations in tropical and subtropical countries. It can range in severity from a mild febrile illness to multisystem involvement. Systemic dysfunction often appears in the second week of sickness, and hepatic, renal and brain involvement are well documented. Although encephalitis is the most frequent neurological ailment, a wide range of unusual complications involving the central and peripheral nervous systems have been identified-however, concomitant multiaxial involvement of the central and peripheral nervous systems is unique. We report a case of a young man with serologically confirmed scrub typhus presenting with fever, eschar, altered sensorium and progressive quadriplegia with hyporeflexic deep tendon reflexes. MRI revealed changes suggestive of encephalitis, and there was evidence of axonopathy on nerve conduction studies. A diagnosis of scrub typhus encephalitis with concomitant Guillain-Barré syndrome was made. He received doxycycline and intravenous immunoglobulin therapy, in addition to supportive treatment.

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Publisher Full Text (DOI)

Authors+Show Affiliations

Modi T
Department of Internal Medicine, GMCH, Chandigarh, India.
Sood T
Department of Internal Medicine, GMCH, Chandigarh, India.
Moudgil S
Radiodiagnosis, GMCH, Chandigarh, India.
Arora N
Department of Internal Medicine, PGIMER, Chandigarh, India aroranavneet1045@gmail.com.

MeSH

MaleHumansScrub TyphusGuillain-Barre SyndromeDoxycyclineImmunoglobulins, IntravenousEncephalitisOrientia tsutsugamushi

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

36990652

Citation

Modi, Tanish, et al. "Neurological Manifestations of Scrub Typhus: Encephalitis and Guillain-Barré Syndrome (GBS)." BMJ Case Reports, vol. 16, no. 3, 2023.
Modi T, Sood T, Moudgil S, et al. Neurological manifestations of scrub typhus: encephalitis and Guillain-Barré syndrome (GBS). BMJ Case Rep. 2023;16(3).
Modi, T., Sood, T., Moudgil, S., & Arora, N. (2023). Neurological manifestations of scrub typhus: encephalitis and Guillain-Barré syndrome (GBS). BMJ Case Reports, 16(3). https://doi.org/10.1136/bcr-2022-253350
Modi T, et al. Neurological Manifestations of Scrub Typhus: Encephalitis and Guillain-Barré Syndrome (GBS). BMJ Case Rep. 2023 Mar 29;16(3) PubMed PMID: 36990652.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Neurological manifestations of scrub typhus: encephalitis and Guillain-Barré syndrome (GBS). AU - Modi,Tanish, AU - Sood,Tina, AU - Moudgil,Sandeep, AU - Arora,Navneet, Y1 - 2023/03/29/ PY - 2025/03/29/pmc-release PY - 2023/3/31/medline PY - 2023/3/29/entrez PY - 2023/3/30/pubmed KW - Infectious diseases KW - Intensive care KW - Neurology KW - Tropical medicine (infectious disease) JF - BMJ case reports JO - BMJ Case Rep VL - 16 IS - 3 N2 - Scrub typhus is a tropical febrile illness that mainly affects rural populations in tropical and subtropical countries. It can range in severity from a mild febrile illness to multisystem involvement. Systemic dysfunction often appears in the second week of sickness, and hepatic, renal and brain involvement are well documented. Although encephalitis is the most frequent neurological ailment, a wide range of unusual complications involving the central and peripheral nervous systems have been identified-however, concomitant multiaxial involvement of the central and peripheral nervous systems is unique. We report a case of a young man with serologically confirmed scrub typhus presenting with fever, eschar, altered sensorium and progressive quadriplegia with hyporeflexic deep tendon reflexes. MRI revealed changes suggestive of encephalitis, and there was evidence of axonopathy on nerve conduction studies. A diagnosis of scrub typhus encephalitis with concomitant Guillain-Barré syndrome was made. He received doxycycline and intravenous immunoglobulin therapy, in addition to supportive treatment. SN - 1757-790X UR - https://www.unboundmedicine.com/medline/citation/36990652/Neurological_manifestations_of_scrub_typhus:_encephalitis_and_Guillain_Barré_syndrome__GBS__ DB - PRIME DP - Unbound Medicine ER -