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Hemorrhagic Transformation of Scrub Typhus Encephalitis: A Rare Entity

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Abstract

Central nervous system (CNS) involvement of scrub typhus infection is well known. Most CNS involvement of scrub typhus infection present as meningitis or encephalitis. We report on a patient suffering from hemorrhagic transformation of intracranial lesions caused by Orientia tsutsugamushi. A 53-year-old female farmer who was infected by scrub typhus was treated with doxycycline and recovered from the systemic illness. However, headache persisted. Brain radiologic studies revealed acute intracranial hemorrhage and enhancing lesion, which implied a CNS involvement. Hemorrhagic transformation of encephalitis by scrub typhus is very rare complication and to our best knowledge, this is the first report of hemorrhagic transformation of scrub typhus encephalitis. Clinician should consider the possibility of hemorrhagic transformation of encephalitis in cases of scrub typhus infection.

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References

  1. Kim DM, Kim SW, Choi SH, Yun NR. Clinical and laboratory findings associated with severe scrub typhus. BMC Infect Dis. 2010;10:108.

    Article  PubMed Central  PubMed  Google Scholar 

  2. Pai H, Sohn S, Seong Y, Kee S, Chang WH, Choe KW. Central nervous system involvement in patients with scrub typhus. Clin Infect Dis. 1997;24:436–40.

    Article  CAS  PubMed  Google Scholar 

  3. Seong SY, Choi MS, Kim IS. Orientia tsutsugamushi infection: overview and immune responses. Microbes Infect. 2001;3:11–21.

    Article  CAS  PubMed  Google Scholar 

  4. Kim DM, Kim KY, Nam HS, Kweon SS, Park MY, Ryu SY. Risk-factors for human infection with Orientia tsutsugamushi: a case-control study in Korea. Clin Microbiol Infect. 2008;14:174–7.

    Article  PubMed  Google Scholar 

  5. Kim DE, Lee SH, Park KI, Chang KH, Roh JK. Scrub typhus encephalomyelitis with prominent focal neurologic signs. Arch Neurol. 2000;57:1770–2.

    Article  CAS  PubMed  Google Scholar 

  6. Kim DM, Kim YS, Cho HY, Lee YB. Scrub typhus meningoencephalitis occurring during doxycycline therapy for Orientia tsutsugamushi. Diagn Microbiol Infect Dis. 2011;69:271–4.

    Article  PubMed  Google Scholar 

  7. Varghese GM, Mathew A, Kumar S, Abraham OC, Trowbridge P, Mathai E. Differential diagnosis of scrub typhus meningitis from bacterial meningitis using clinical and laboratory features. Neurol India. 2013;61:17–20.

    Article  PubMed  Google Scholar 

  8. Choi YH, Kim SJ, Lee JY, Pai HJ, Lee KY, Lee YS. Scrub typhus: radiological and clinical findings. Clin Radiol. 2000;55:140–4.

    Article  CAS  PubMed  Google Scholar 

  9. Yum KS, Na S-J, Lee KO, Ko JH. Scrub typhus meningoencephalitis with focal neurologic signs and associated brain MRI abnormal findings: literature review. Clin Neurol Neurosurg. 2011;113:250–3.

    Article  PubMed  Google Scholar 

  10. Lee KL, Lee JK, Yim YM, Lim OK, Bae KH. Acute transverse myelitis associated with scrub typhus: case report and a review of literatures. Diagn Microbiol Infect Dis. 2008;60:237–9.

    Article  PubMed  Google Scholar 

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Acknowledgement

This work was supported by Dankook university research fund in 2014.

Conflict of Interest

The authors declare that there are no conflicts of interest in relation to this article.

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Authors and Affiliations

  1. Department of Neurosurgery, Dankook University College of Medicine, 201 Manghyang-ro Dongnam-gu, 330–715, Cheonan, Chungnam, Republic of Korea

    H.-C. Kim MD, K.-W. Yoon MD, D.-S. Yoo MD, PhD & C.-S. Cho MD, PhD

  2. Department of Radiology, Dankook University College of Medicine, Cheonan, Chungnam, Republic of Korea

    D.-S. Yoo MD, PhD

Authors
  1. H.-C. Kim MD
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  2. K.-W. Yoon MD
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  3. D.-S. Yoo MD, PhD
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  4. C.-S. Cho MD, PhD
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Corresponding author

Correspondence to C.-S. Cho MD, PhD.

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Kim, HC., Yoon, KW., Yoo, DS. et al. Hemorrhagic Transformation of Scrub Typhus Encephalitis: A Rare Entity. Clin Neuroradiol 25, 415–418 (2015). https://doi.org/10.1007/s00062-014-0348-9

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  • DOI: https://doi.org/10.1007/s00062-014-0348-9

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