Neurological manifestations of scrub typhus in adults

2016 ◽  
Vol 47 (1) ◽  
pp. 22-25 ◽  
Author(s):  
Abhinav Rana ◽  
Sanjay K Mahajan ◽  
Arindam Sharma ◽  
Sudhir Sharma ◽  
Balbir S Verma ◽  
...  
Keyword(s):  
Scrub Typhus ◽  
Transverse Myelitis ◽  
Neurological Dysfunction ◽  
Neurological Manifestations ◽  
Focal Neurological Deficit ◽  
Altered Sensorium ◽  
Csf Analysis ◽  
Acute Transverse Myelitis ◽  
The Right ◽  
Bilateral Papilloedema

In order to study the neurological manifestations in adult patients suffering from scrub typhus, 323 patients aged over 18 years, admitted with a positive diagnosis, were screened for neurological dysfunction; 37 patients with symptoms and/or signs suggestive of neurological dysfunction were included in the study. Of these, 31 (84%) patients had altered sensorium, four (11%) had cerebellitis, one (2%) patient had acute transverse myelitis and one (2%) had bilateral papilloedema without focal neurological deficit. Of the 31 patients with altered sensorium, 15 (40%) had meningoencephalitis, three (8%) had seizures, two (5%) had cerebral haemorrhages, one (2%) had a presentation likened to neuroleptic malignant syndrome (NMS) and one (2%) had a 6th nerve palsy with inflammation of the right cavernous sinus. Cerebrospinal fluid (CSF) analysis was abnormal in 23 patients (raised lymphocytes in 68%, raised protein in 80%). All patients improved with anti-rickettsial therapy.

Acute transverse myelitis associated with scrub typhus: case report and a review of literatures

2008 ◽  
Vol 60 (2) ◽  
pp. 237-239 ◽  
Author(s):  
Kwang Lae Lee ◽  
Ju Kang Lee ◽  
Yoon Myung Yim ◽  
Oh Kyung Lim ◽  
Keun Hwan Bae
Keyword(s):  
Case Report ◽  
Scrub Typhus ◽  
Transverse Myelitis ◽  
Acute Transverse Myelitis

scholarly journals Neuropsychiatric Manifestations of Scrub Typhus

2017 ◽  
Vol 08 (03) ◽  
pp. 421-426 ◽  
Author(s):  
Sanjay K. Mahajan ◽  
Sanyam K. Mahajan
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Clinical Picture ◽  
Scrub Typhus ◽  
Case Reports ◽  
Transverse Myelitis ◽  
Neurological Manifestations ◽  
Orientia Tsutsugamushi ◽  
Cranial Nerve Palsies ◽  
Neuropsychiatric Manifestations

ABSTRACTScrub typhus is caused by Orientia tsutsugamushi characterized by focal or disseminated vasculitis and perivasculitis which may involve the lungs, heart, liver, spleen and central nervous system. It was thought to have been eradicated from India. Recently it is being reported from many areas of India. The clinical picture and severity of the symptoms varies widely. The neurological manifestations of scrub typhus are not uncommon but are diverse. Meningoencephalitis is classical manifestation of scrub typhus but cerebellitis, cranial nerve palsies, plexopathy, transverse myelitis, neuroleptic malignant syndrome and Guillan-Barré syndrome are other manifestations reported in literature. The availability of literature on the neurological manifestations of scrub typhus is limited to case reports mainly. This article reviews various neurological manifestations of scrub typhus reported in literature.

Abstract 1122‐000013: Spinal Dural Arterio‐Venous Fistula: A Masquerade as a Longitudinal Myelitis

2021 ◽  
Vol 1 (S1) ◽  
Author(s):  
Amardeep Saund ◽  
Saleem Al Mawed ◽  
Adnan Subei ◽  
Brijesh Mehta
Keyword(s):  
Delayed Diagnosis ◽  
Transverse Myelitis ◽  
Diagnostic Feature ◽  
Segmental Artery ◽  
Csf Analysis ◽  
Digital Subtraction Angiogram ◽  
Venous Fistula ◽  
The Right ◽  
High Index Of Suspicion ◽  
Extensive Transverse Myelitis

Introduction : SDAVF are rare and frequently misdiagnosed due to their nonspecific symptomatology and delay of presentation on imaging. Spinal digital subtraction angiogram is the gold standard diagnostic test. Delayed diagnosis and treatment of SDAVF can lead to irreversible neurologic damage. Methods : None Results : Two female patients, 69 and 74 years old, each developed recurrent episodes of subacute worsening myelopathy and urinary retention. The subacute onset of symptoms and longitudinal appearance on cord imaging raised concern for inflammatory myelitis. Despite a negative CSF analysis, and the absence of serum inflammatory, metabolic and infectious markers, the working diagnosis was seronegative neuromyelitis optica spectrum disorder. In accordance, both patients were treated with plasma exchange and IV rituximab, initially displaying stabilization on imaging. However, further worsening and extension of the myelopathy alongside the presence of flow voids in one patient’s repeat MRI nine months post‐presentation raised the question of an alternate etiology. A spinal angiogram was ordered for the patient, revealing SDAVF. Subsequently, the patient underwent complete Onyx embolization of the right L2 feeder and surgical clipping of the right L1 feeder. This resulted in stabilization and improvement of symptoms. Although the second patient did not display flow voids in their MRI, they were ordered a spinal angiogram due to their similar clinical course, indeed confirming SDAVF. The patient underwent successful complete embolization of the L3 segmental artery on the right resulting in improvement of symptoms. Conclusions : Clinicians should have a high index of suspicion for SDAVF when a patient presents with a longitudinally extensive transverse myelitis negative for inflammatory markers and is unresponsive to treatment. While the appearance of flow voids on imaging is a helpful diagnostic feature, these may not be present in patients.

scholarly journals Acute Transverse Myelitis (Ascending Myelitis) as the Initial Manifestation of Japanese Encephalitis: A Rare Presentation

2013 ◽  
Vol 2013 ◽  
pp. 1-3
Author(s):  
Varshney Ankur Nandan ◽  
Kumar Nilesh ◽  
Behera Dibyaranjan ◽  
Tiwari Ashutosh ◽  
Anand Ravi ◽  
...  
Keyword(s):  
Japanese Encephalitis ◽  
Vasogenic Edema ◽  
Brain Mri ◽  
Transverse Myelitis ◽  
Internal Capsule ◽  
Endemic Region ◽  
Rare Presentation ◽  
Initial Manifestation ◽  
Altered Sensorium ◽  
Acute Transverse Myelitis

Japanese encephalitis, an inflammatory brain disease prevalent in Southeast Asia, usually presented with fever, headache, convulsions, brain stem signs with pyramidal and extrapyramidal features, and altered sensorium. Acute transverse myelitis, as the initial manifestation of Japanese encephalitis, is an unusual manifestation and is seldom reported. We hereby report a case of 13-year-old adolescent boy who presented to us with fever and acute onset paraparesis with urinary retention initially, progressing to quadriparesis and then followed by headache and altered sensorium. Brain MRI revealed bilateral basal ganglia that were grossly swollen with vasogenic edema tracking along internal capsule and midbrain. Adjacent ventrolateral thalamus and internal capsule also showed mild abnormal intensities. Spinal screening showed abnormal cord intensities in entire cord with gross edema in cervical and conus regions. He had elevated IgM titres against JE virus in cerebrospinal fluid. The patient was treated conservatively along with intravenous methyl prednisolone for 5 days. He regained near normal power at 3 months in followup, but hesitancy, dysarthria, and slowness of movement still persisted. To conclude, a young boy presenting with ATM in an endemic region of JE, then a possibility of Japanese encephalitis, should be sought by clinicians as early use of immunomodulator shows survival benefit.

scholarly journals Case Report: Acute Transverse Myelitis

2021 ◽  
Vol 9 (T3) ◽  
pp. 182-185
Author(s):  
Petrus Nilwan Ginting ◽  
Kiking Ritarwan
Keyword(s):  
Spinal Cord ◽  
Motor Neuron ◽  
Transverse Myelitis ◽  
Magnetic Resonance Imaging Examination ◽  
Inflammatory Disorder ◽  
Case Presentation ◽  
Acute Transverse Myelitis ◽  
Sensory Disturbances ◽  
The Right ◽  
Whole Spine

BACKGROUND: Acute transverse myelitis (ATM) could be a pathogenetically heterogeneous inflammatory disorder affecting the spinal cord at one or more segments [1]. CASE PRESENTATION: We report a 69-year-old man presented with complaints of weakness of the arms and legs since 3 weeks before hospital admission. On physical and neurological examination was found Tetraparese, lower motor neuron in the superior limb and upper motor neuron in the inferior limb, sensory disturbances at C6-C7 levels, and autonomic impairment retention of urine and bladder dysfunction. On magnetic resonance imaging examination of the whole spine vertebra, a diffuse process was found in the spinal cord along with the cervical 7 to Th12-L1. Differential diagnosis is with transverse myelitis, multiple sclerosis, and no picture of syringomyelia. The patient was treated with steroids. Acute transverse myelitis is an inflammatory disorder of the spinal cord with various causes. CONCLUSION: Clinical examination and investigations are very important to establish the diagnosis and determine the right management so that the expected outcome is obtained.

scholarly journals Acute Transverse Myelitis Caused by Echovirus 11 in a Pediatric Patient

2018 ◽  
Vol 5 ◽  
pp. 2329048X1775152 ◽  
Author(s):  
Heidi L. Moline ◽  
Peter I. Karachunski ◽  
Anna Strain ◽  
Jayne Griffith ◽  
Cynthia Kenyon ◽  
...  
Keyword(s):  
Transverse Myelitis ◽  
Interdisciplinary Team ◽  
Cervical Cord ◽  
Acute Flaccid Myelitis ◽  
Department Of Health ◽  
Acute Transverse Myelitis ◽  
Pediatric Neurologist ◽  
The Right ◽  
Infectious Etiology ◽  
Pediatric Infection

A 12-year-old boy presented with acute flaccid weakness of the right upper extremity and was found to have acute flaccid myelitis with transverse myelitis involving the cervical cord (C1-T1). An interdisciplinary team-based approach was undertaken, including input from a generalist, an infectious diseases physician, and a pediatric neurologist. Consultation was sought from the Minnesota Department of Health to investigate for a potential etiology and source of the responsible infection. Evaluation for an infectious etiology demonstrated infection with human echovirus 11. The patient recovered with some disability. Echovirus 11 is among the more common etiologies of acute flaccid myelitis and should be considered in the differential diagnosis of this increasingly recognized pediatric infection.

scholarly journals Successfully Managed Acute Transverse Myelitis Related to Scrub Typhus and Serial Image Findings

2017 ◽  
pp. 16-0524
Author(s):  
Jae Sung Yun ◽  
Ji Soo Song ◽  
Eun Jung Choi ◽  
Jeong-Hwan Hwang ◽  
Chang-Seop Lee ◽  
...  
Keyword(s):  
Scrub Typhus ◽  
Transverse Myelitis ◽  
Acute Transverse Myelitis

scholarly journals Acute transverse myelitis following scrub typhus: A case report and review of the literature

2018 ◽  
Vol 43 (4) ◽  
pp. 548-551
Author(s):  
Hyun-Seung Ryu ◽  
Bong Ju Moon ◽  
Jae-Young Park ◽  
Sang-Deok Kim ◽  
Seung-Kwon Seo ◽  
...  
Keyword(s):  
Case Report ◽  
Scrub Typhus ◽  
Transverse Myelitis ◽  
Review Of The Literature ◽  
Acute Transverse Myelitis

scholarly journals Neurological Manifestations and Complications of COVID-19: A Literature Review

2020 ◽  
Author(s):  
Imran Ahmad ◽  
Farooq Azam Rathore
Keyword(s):  
Case Reports ◽  
Case Series ◽  
Transverse Myelitis ◽  
Neurological Complications ◽  
Neurological Manifestations ◽  
Wuhan City ◽  
Acute Transverse Myelitis ◽  
Acute Encephalitis ◽  
Novel Virus ◽  
High Index Of Suspicion

The Coronavirus disease due to SARS-CoV-2 emerged in Wuhan city, China in December 2019 and rapidly spread more than 200 countries as a global health pandemic. There are more 3 million confirmed cases and around 207,000 fatalities. The primary manifestation is respiratory and cardiac but neurological manifestations are being reported in the literature as case reports and case series. The most common reported symptoms to include headache and dizziness followed by encephalopathy and delirium. Among the complications noted are Cerebrovascular accident, Guillian barre syndrome, acute transverse myelitis, and acute encephalitis. The most common peripheral manifestation was hyposmia. It is further noted that sometimes the neurological manifestations can precede the typical features like fever and cough and later on typical manifestations develop in these patients. Hence a high index of suspicion is required for timely diagnosis and isolation of cases to prevent the spread in neurology wards. We present a narrative review of the neurological manifestations and complications of COVID-19. Our aim is to update the neurologists and physicians working with suspected cases of COVID-19 about the possible neurological presentations and the probable neurological complications resulting from this novel virus infection.

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