Acute febrile infant with stridor: Rare presentation of pediatric scrub typhus

This is a rare presentation of scrub typhus with cerebral venous thrombosis. A 32-year-old woman presented with signs of raised intracranial tension. Examination revealed maculopapular skin rashes and an ‘eschar’ over the right thigh. Nuchal rigidity and bilateral papilloedema were found. Scrub typhus was diagnosed by the presence of IgM antibody in serum. CT scan of the brain showed cerebral oedema. MRI of the brain was normal. Magnetic resonance venography of the brain showed thrombosis of several venous sinuses. Cerebrospinal fluid analysis revealed lymphocytic pleocytosis with raised protein level. Other causes of prothrombotic states were ruled out by doing specific test results. There was no history of hormonal contraception and prolonged bed rest. A case of scrub typhus complicated with meningoencephalitis and cerebral venous thrombosis was diagnosed. She responded to treatment with doxycycline, anticoagulants, antipyrectics and intravenous saline. Early identification of such atypical neurological involvement in scrub typhus was helpful in satisfactory outcome.

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Stye Can Lie! – A Rare Presentation of Scrub Typhus Eschar

The Indian Journal of Pediatrics ◽

10.1007/s12098-020-03303-1 ◽

2020 ◽

Author(s):

Dinesh Kumar Narayanasamy ◽

Thirunavukkarasu Arun Babu

Keyword(s):

Scrub Typhus ◽

Rare Presentation

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Scrub Typhus with a Rare Presentation in a Child- A Case Report

Journal of Medical Science And clinical Research ◽

10.18535/jmscr/v5i4.39 ◽

2017 ◽

Vol 05 (04) ◽

pp. 19968-19970

Author(s):

Aroop Mohanty ◽

Keyword(s):

Case Report ◽

Scrub Typhus ◽

Rare Presentation

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Massive splenomegaly in scrub typhus: A rare presentation

IDCases ◽

10.1016/j.idcr.2019.e00680 ◽

2020 ◽

Vol 19 ◽

pp. e00680

Author(s):

Virendra Atam ◽

Avirup Majumdar ◽

D. Himanshu ◽

Vivek Kumar ◽

Isha Atam

Keyword(s):

Scrub Typhus ◽

Massive Splenomegaly ◽

Rare Presentation

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Splenic infarct with scrub typhus: a rare presentation

Tropical Doctor ◽

10.1177/0049475519892092 ◽

2019 ◽

Vol 50 (3) ◽

pp. 234-236 ◽

Cited By ~ 2

Author(s):

Manjeet K Goyal ◽

Yogesh C Porwal ◽

Arun Gogna ◽

Sameer Gulati

Keyword(s):

Scrub Typhus ◽

Febrile Illness ◽

Splenic Infarction ◽

North India ◽

Computed Tomography Scan ◽

Rare Presentation ◽

Splenic Infarct ◽

Igm Elisa ◽

Clinical Presentations ◽

Tomography Scan

Scrub typhus has a variety of clinical presentations ranging from asymptomatic to fever with chills, myalgias, hepatitis, gastric ulcerations and pancreatitis, all being attributed to disseminated vasculitis, with splenic infarction being a rare presentation. A 26-year man, a resident of north India, presented with an acute febrile illness and abdominal pain, computed tomography scan of the abdomen was suggestive of a splenic infarct. After ruling out other aetiology, a positive IgM (ELISA) for scrub typhus led to treatment with oral doxycycline, following which the patient was discharged symptom-free. Rarely can splenic infarction be attributable to scrub typhus; so far, five such cases have been reported in the published literature.

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Multiple eschars in scrub typhus: a case report

Tropical Doctor ◽

10.1177/0049475516658400 ◽

2016 ◽

Vol 47 (1) ◽

pp. 67-69

Author(s):

Munegowda Koraluru ◽

Manideep Nandigam ◽

Indira Bairy ◽

Sudha Vidyasagar ◽

Muralidhar Varma

Keyword(s):

Scrub Typhus ◽

Specific Antigen ◽

Orientia Tsutsugamushi ◽

Febrile Patient ◽

Chain Reaction ◽

Rare Presentation ◽

Nested Polymerase Chain Reaction ◽

Appropriate Therapy ◽

Polymerase Chain ◽

Edta Blood

Eschar in scrub typhus aids in early diagnosis and institution of appropriate therapy; however, the eschar positivity rates vary greatly in endemic regions. Multiple eschars in scrub typhus are a rare presentation. Our patient presented with fever and multiple eschars and was empirically started on doxycycline. Nested polymerase chain reaction from all the four eschars and from EDTA blood were positive for 56-kDa type-specific antigen which is specific for Orientia tsutsugamushi. The patient recovered completely after 7 days of antibiotic treatment. He was from an area where scrub typhus was not observed previously. An eschar in an acute febrile patient from the “tsutsugamushi triangle” is a valuable sign in scrub typhus diagnosis. A search for multiple eschars in scrub typhus must be made by clinicians.

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Acute cerebellar ataxia: a rare presentation of scrub typhus in pediatric age group

IP International Journal of Medical Paediatrics and Oncology ◽

10.18231/j.ijmpo.2021.043 ◽

2021 ◽

Vol 7 (4) ◽

pp. 215-217

Author(s):

Bhupesh Jain ◽

Rameshwar Ninama ◽

Mukesh Kumar Gurjar ◽

Lalit Pal Katara

Keyword(s):

Cerebellar Ataxia ◽

Scrub Typhus ◽

The Body ◽

Age Group ◽

Rare Presentation ◽

Pediatric Age Group ◽

Igm Elisa ◽

Acute Cerebellar Ataxia ◽

Atypical Presentations ◽

Almost All

Scrub typhus is known to cause local and systemic vasculitic response in almost all the systems of the body. Scrub typhus very rarely presents itself with CNS manifestations. In central nervous system it most commonly causes meningitis and encephalitis although several other atypical presentations have been documented. Cerebellar ataxia, which is the lack of coordination, has a number of causes none of which are as uncommon or unheard of as Scrub Typhus. We report a case of a 15 years old child presenting with fever and isolated acute cerebellitis. Scrub Typhus was diagnosed by serum IgM ELISA. Patient showed rapid response to doxycycline therapy.

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