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Scrub typhus with cerebral venous sinus thrombosis: a rare presentation
  1. Sayonee Das1,
  2. Sidhartha Chattopadhyay2,
  3. Kausik Munsi1 and
  4. Sagar Basu2
  1. 1Internal Medicine, KPC Medical College and Hospital, Jadavpur, West Bengal, India
  2. 2Neuro-Medicine, KPC Medical College and Hospital, Jadavpur, West Bengal, India
  1. Correspondence to Dr Sagar Basu; drsagar.basu{at}gmail.com

Abstract

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.

  • infections
  • neurology (drugs and medicines)
  • infectious diseases
  • infection (neurology)

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Footnotes

  • Twitter @SidharthaChat14

  • Contributors SD and SC analysed clinical data and drafted the initial manuscript. KM contributed to discussions and reviewed the manuscript. SB critically reviewed the manuscript including the references and gave it the final shape. All the authors critically reviewed the manuscript for intellectual contents and approved the final version and were accountable for all aspects of the work in terms of accuracy and integrity.

  • 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.

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

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