Evoked response audiometry in scrub typhus: prospective, randomised, case–control study

Thakur, Jagdeep S; Mohindroo, NK; Sharma, Devesh; Soni, Kapil Dev; Kaushal, Sonali

doi:10.1017/s0022215111000107

Cited by 6 publications

(7 citation statements)

References 13 publications

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“…Otalgia occurs in the first week, while sensorineural hearing loss and tinnitus occur during the second week [35]. Cochlear and retrocochlear damage has been proven histopathologically with demyelination and patchy neuritis having been noted in the 7 th and 8 th cranial nerves [9]. Lymphocytic infiltrate of the organ of Corti and the coclear nerve have been described [9].…”

Section: Discussionmentioning

confidence: 99%

“…Cochlear and retrocochlear damage has been proven histopathologically with demyelination and patchy neuritis having been noted in the 7 th and 8 th cranial nerves [9]. Lymphocytic infiltrate of the organ of Corti and the coclear nerve have been described [9]. Hearing loss has been reported in R. conorii [35].…”

Section: Discussionmentioning

confidence: 99%

“…The larval forms (chiggers) of the trombiculid mite transmit the disease to humans and other vertebrates [9]. The mite has four life cycle stages: egg, larva, nymph and adult [9].…”

Section: Introductionmentioning

confidence: 99%

“…The mite has four life cycle stages: egg, larva, nymph and adult [9]. Horizontal transmission occurs in rodents and humans get accidentally infected following bites of chiggers [10].…”

Section: Introductionmentioning

confidence: 99%

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Scrub Typhus Meningitis in South India — A Retrospective Study

et al. 2013

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BackgroundScrub typhus is prevalent in India although definite statistics are not available. There has been only one study on scrub typhus meningitis 20 years ago. Most reports of meningitis/meningoencephalitis in scrub typhus are case reportsMethodsA retrospective study done in Pondicherry to extract cases of scrub typhus admitted to hospital between February 2011 and January 2012. Diagnosis was by a combination of any one of the following in a patient with an acute febrile illness- a positive scrub IgM ELISA, Weil-Felix test, and an eschar. Lumbar puncture was performed in patients with headache, nuchal rigidity, altered sensorium or cranial nerve deficits.ResultsSixty five cases of scrub typhus were found, and 17 (17/65) had meningitis. There were 33 males and 32 females. Thirteen had an eschar. Median cerebrospinal fluid (CSF) cell count, lymphocyte percentage, CSF protein, CSF glucose/blood glucose, CSF ADA were 54 cells/µL, 98%, 88 mg/dL, 0.622 and 3.5 U/mL respectively. Computed tomography was normal in patients with altered sensorium and cranial nerve deficits. Patients with meningitis had lesser respiratory symptoms and signs and higher urea levels. All patients had received doxycycline except one who additionally received chloramphenicol.ConclusionMeningitis in scrub typhus is mild with quick and complete recovery. Clinical features and CSF findings can mimic tuberculous meningitis, except for ADA levels. In the Indian context where both scrub typhus and tuberculosis are endemic, ADA and scrub IgM may be helpful in identifying patients with scrub meningitis and in avoiding prolonged empirical antituberculous therapy in cases of lymphocytic meningitis.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

“…The larval forms (chiggers) of the trombiculid mite transmit the disease to humans and other vertebrates [9]. The mite has four life cycle stages: egg, larva, nymph and adult [9].…”

Section: Introductionmentioning

confidence: 99%

“…The mite has four life cycle stages: egg, larva, nymph and adult [9]. Horizontal transmission occurs in rodents and humans get accidentally infected following bites of chiggers [10].…”

Section: Introductionmentioning

confidence: 99%

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Scrub Typhus Meningitis in South India — A Retrospective Study

et al. 2013

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“…[ 2 ] The disease is transmitted to humans by the bite of the larvae Leptotrombidium mite (chigger). [ 3 ] The disease often appears as a nonspecific febrile illness. The clinical pictures of scrub typhus are typically associated with fever, rash, myalgia, and diffuse lymphadenopathy.…”

Section: Introductionmentioning

confidence: 99%

Tsutsugamushi disease (scrub typhus) meningoencephalitis in north eastern India: A prospective study

Sharma¹,

Masaraf²,

Lynrah³

et al. 2015

Ann Med Health Sci Res

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Background:Scrub typhus is rampant in northern, eastern, and southern India. Central nervous system involvement in the form of meningitis or meningoencephalitis is common in scrub typhus. As specific laboratory methods remain inadequate or inaccessible in developing countries, prompt diagnosis is often difficult.Aim:The aim of this study was to characterize neurological complications in scrub typhus from northeastern region of India.Subjects and Methods:We did a prospective study of scrub meningoencephalitis at North Eastern Indira Gandhi Regional Institute of Medical Sciences among patients admitted to hospital between October 2009 and November 2011. The diagnosis was made based on the clinical pictures, presence of an eschar, and a positive Weil–Felix test (WFT) with a titer of >1:160 and if required a positive scrub IgM enzyme-linked immunosorbent assay. Lumbar puncture was performed in patients with headache, nuchal rigidity, altered sensorium or cranial nerve deficits, and magnetic resonance imaging (MRI) brain performed if needed.Results:Twenty-three patients of scrub typhus meningitis that were serologically confirmed were included in the study. There were 13 males and 10 females. Fever ≥1 week was the most common manifestation (39.1%). Interestingly, none had an eschar. Median cerebrospinal fluid (CSF) cell count, lymphocyte percentage, CSF protein, CSF glucose/blood glucose, CSF ADA were 17 cells/μL, 90%, 86 mg/dL, 0.6605 and 3.6 U/mL, respectively. All patients were treated with doxycycline. There was no mortality in our study.Conclusions:Absence of Eschar does not rule out scrub typhus. Clinical features and CSF findings can mimic tuberculous meningitis so misdiagnosis may lead to unwarranted prolonged empirical antituberculous therapy in cases of lymphocytic meningoencephalitis. Delay in treatment can be potentially fatal. WFT still serves as a useful and affordable diagnostic tool for this disease in resource-poor countries.

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Neurological Manifestations of Scrub Typhus

Basu

Chakravarty

2022

Curr Neurol Neurosci Rep

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Evoked response audiometry in scrub typhus: prospective, randomised, case–control study

Cited by 6 publications

References 13 publications

Scrub Typhus Meningitis in South India — A Retrospective Study

Scrub Typhus Meningitis in South India — A Retrospective Study

Tsutsugamushi disease (scrub typhus) meningoencephalitis in north eastern India: A prospective study

Neurological Manifestations of Scrub Typhus

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