Abstract

Scrub typhus is an acute febrile illness caused by <i>Orientia tsutsugamushi</i>. The most common neurological symptoms are headaches presenting with meningitis, meningoencephalitis, or encephalitis; however, transverse myelopathy and polyneuropathy are rare in typhoid infections. Herein, we report a laboratory and electrodiagnostically proven case of subacute myelopathy and polyneuropathy with slow progression after scrub typhus infection. A 64-year-old man complained of truncal numbness and a burning sensation in both feet. Magnetic resonance imaging did not reveal any definite changes in the spinal cord; however, serological tests showed immunoglobulin G antibodies against O. tsutsugamushi by enzyme-linked immunosorbent assay. An electrophysiological study showed myelopathy concurrent with polyneuropathy. To the best of our knowledge, this is the first immunochemical detection of antibodies in a patient with delayed neurological manifestations after scrub typhus infection.

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