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Case report
Posterior reversible encephalopathy syndrome in scrub typhus fever
  1. Vivek Naveen,
  2. Saurabh Gaba,
  3. Monica Gupta and
  4. Daljinderjit Kaur
  1. Department of General Medicine, Government Medical College and Hospital, Chandigarh, India
  1. Correspondence to Professor Monica Gupta; monicamanish2001{at}


The clinical course of a 40-year-old female patient, who presented with acute febrile illness due to scrub typhus fever became complicated by seizures and posterior reversible encephalopathy syndrome (PRES), leading to a fatal outcome. She had normal blood pressure at admission; however, she later developed hypotension and shock. PRES is a syndrome of vasogenic cerebral oedema and accompanying neurological deficits resulting from the breakdown of blood-brain barrier due to high blood pressure or radical blood pressure changes. PRES is a clinico-radiographic diagnosis of heterogeneous aetiologies and is rare in the context of infections. Although there are many neurological manifestations in scrub typhus, to the best of our knowledge, PRES has never been reported.

  • infectious diseases
  • tropical medicine (infectious disease)
  • infection (neurology)

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  • Contributors All the authors have provided substantial contributions in the clinical management of the case and literature review on the topic in question. VN and SG have drafted the manuscript, and MG and DK have revised it critically for important intellectual content. All the authors have read the final version and approved it. All the authors agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Next of kin consent obtained.

  • Provenance and peer review Not commissioned; externally peer-reviewed.