Volume 27, Issue 132, February 2023

A rare presentation of neurological scrub typhus with hydrocephalus: Case report

Yarraiahgari Maheswara^1♦, Revat Meshram², Jayant Vagha³, Amar Taksande⁴

¹Post Graduate student, Department of paediatrics, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Sawangi, Meghe, Wardha, Maharashtra, India, Pincode-442004
²MD Associate Professor, Department of Paediatrics, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Sawangi, Meghe, Wardha, Maharashtra, India, Pincode-442004
³MD Professor, Department of Paediatrics, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Sawangi, Meghe, Wardha, Maharashtra, India, Pincode-442004
⁴MD Professor, Head of Department, Department of Paediatrics, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Sawangi, Meghe, Wardha, Maharashtra, India, Pincode-442004

^♦Corresponding author
Post Graduate student, Department of Paediatrics, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Sawangi, Meghe, Wardha, Maharashtra, India

ABSTRACT

Scrub typhus is zoonotic disease caused by Orientia tsutsugamushi. Scrub typhus transmits to human beings by arthropod vector of the Trombiculidae family (Leptotrombidium deliense and L. akamushi). The incidence of this disease is rising in various parts of India. Clinical manifestations could range from constitutional symptoms like fever, weakness, anorexia and headache to dermatological manifestations like eschar, lymphadenopathy and maculopapular rash. Eschar is considered pathognomic in suspecting scrub typhus. Complications of the disease include myocarditis, acute respiratory distress, jaundice, atypical meningitis and kidney failure amongst others. Here, this case report is about a 5-year-old boy who presented with rare complication of scrub typhus which is multiple cranial nerve palsies, meningitis and hydrocephalus. The presence of the characteristic eschar over the abdomen raised the suspicion of Scrub typhus. Diagnosis was confirmed by a positive serology and the patient responded well to medical management with injectable doxycycline.

Keywords: Scrub typhus, Meningitis, Eschar, Cranial nerve palsy, hydrocephalus

Medical Science, 2023, 27, e87ms2725

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DOI: https://doi.org/10.54905/disssi/v27i132/e87ms2725

Published: 14 February 2023