Scrub typhus meningo-encephalitis with focal neurologic signs and associated brain MRI abnormal findings: Literature review

Abstract

An acute febrile disease, scrub typhus is caused by rickettsial nfection transferred by a bite of the chigger larvae infected with rientia tsutsugamushi. It is also known as tsutsugamushi disase and is characterized by focal or disseminated vasculitis and erivasculitis, which may involve the lung, heart, liver, spleen nd central nervous system [1–3]. The main pathologic change s focal or disseminated vasculitis caused by the destruction of ndothelial cells and the perivascular infiltration of leukocytes 1]. Scrub typhus occurs in a wide area of eastern Asia and he western pacific region [3]. It occurs in persons who ngage in occupational or recreational behavior that brings hem into contact with mite-infested habitats such as bush and rass. Scrub typhus can present with neurologic signs resembling septic meningitis or encephalitis syndrome. According to a study y Pai et al., twelve (48%) of 25 patientswith scrub typhus hadmild SF pleocytosis [7]. However, focal neurologic signs and abnormal euroradiologic findings in scrub typhus are rarely reported. We eport a case of scrub typhusmeningo-encephalitis with focal neuologic signs and associated neuroradiologic abnormalities along ith a review of the literature.