Cerebellitis as a rare manifestation of scrub typhus fever

Gupta, Samiksha; Grover, Sahil; Gupta, Monica; Kaur, Daljeet

doi:10.1136/bcr-2019-233993

Cited by 5 publications

(5 citation statements)

References 26 publications

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“…Approximately 20%–25% of patients with scrub typhus suffer from neurological complications, making this an important part of the clinical constellation. [ 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 ...…”

Section: R Esultsmentioning

confidence: 99%

Neurological Facets of Scrub Typhus

Garg¹,

Manesh

2021

Annals of Indian Academy of Neurology

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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.

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Section: R Esultsmentioning

confidence: 99%

Neurological Facets of Scrub Typhus

Garg¹,

Manesh

2021

Annals of Indian Academy of Neurology

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“…MRI may or may not be normal. 7,12 Our case showed T2/FLAIR hyperintensity involving bilateral cerebellum. Scrub typhus response to doxycycline treatment is dramatic.…”

Section: Discussionmentioning

confidence: 57%

“…Previously Gupta et al 7 and Mahajan et al 8 have also reported isolated cerebellitis as a complication of scrub typhus. The likely pathophysiology is microangiopathy leading to focal or disseminated vasculitis or perivasculitis.…”

Section: Discussionmentioning

confidence: 94%

“…Common neurological complications of scrub typhus include state of altered sensorium, aseptic meningitis, seizure, meningoencephalitis. But some rare manifestations include pan-digital gangrene, 4 cerebrovascular accident (CVA), 5 acute disseminated encephalomyelitis (ADEM), cerebellar dysfunction, multiple cranial nerve palsies 6,7 and disseminated intravascular coagulation (DIC). Acute cerebellar ataxia is a rare complication of scrub typhus, which was seen in our patient.…”

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confidence: 99%

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Scrub Typhus with Acute Bilateral Cerebellar Ataxia: A Rare Presentation

Dr MAHESH DAVE,

Dr DEEPANSHU,

Dr NISHANT MANGLA

et al. 2024

IJCP

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Scrub typhus, also known as Bush typhus, is a zoonotic infectious disease predominantly affecting rural and semi urbanareas. It is caused by the bacterium Orientia tsutsugamushi. Scrub typhus is predominantly seen in monsoon and post-monsoonseasons. It a vector-borne disease and has a varying clinical presentation ranging from mild acute febrile illness to lifethreatening multiorgan dysfunction. Neurological manifestations can occur in the form of meningitis, meningoencephalitis,polyneuritis cranialis, intracerebral hemorrhage; rarely, it can cause cerebellar dysfunction. Herein, we report a case of acutebilateral cerebellar ataxia, one of the rare neurological complications of scrub typhus.

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“…The median duration of onset ranges from 3 to 22 days from the start of fever, consistent with our patient’s development of neurological dysfunction on day 10 of illness. Apart from meningitis and meningoencephalitis, other CNS manifestations include cerebellitis, cranial nerve palsies, transverse myelitis, transient parkinsonism, encephalomyelitis, infarctions and haemorrhages 8 9…”

Section: Discussionmentioning

confidence: 99%

Neurological manifestations of scrub typhus: encephalitis and Guillain-Barré syndrome (GBS)

et al. 2023

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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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Cerebellitis as a rare manifestation of scrub typhus fever

Cited by 5 publications

References 26 publications

Neurological Facets of Scrub Typhus

Neurological Facets of Scrub Typhus

Scrub Typhus with Acute Bilateral Cerebellar Ataxia: A Rare Presentation

Neurological manifestations of scrub typhus: encephalitis and Guillain-Barré syndrome (GBS)

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