Scrub Typhus Meningitis versus Acute Bacterial Meningitis—A Clinical-Laboratory Differential Diagnosis

Abstract

Neurologic involvement in scrub typhus in the form of meningitis or meningoencephalitis, and its differentiation from other forms of bacterial and viral meningitis, has not been extensively studied in pediatric population. We compared the clinical and laboratory profiles of children with scrub typhus meningitis (STM) and acute bacterial meningitis (ABM) at a university teaching hospital in North India. Twenty-seven children were diagnosed with acute meningitis over 12 months. Meningitis was diagnosed based on clinical features and abnormal cerebrospinal fluid (CSF) analysis, with either a positive IgM ELISA for scrub typhus (n = 19) or isolation of bacteria known to cause ABM from CSF (n = 8). The children with STM were significantly older (7.8 ± 4.9 vs. 4.5 ± 4.9 years; p = 0.029), had longer duration of fever (7.9 ± 2.7 vs. 3.4 ± 2.1 days; p