Distinguishing scrub typhus–related deltoid paralysis from cervical spondylosis in an elderly patient: a case report
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Scrub typhus is a zoonotic rickettsial infection disease in the special area named the ‘tsutsugamushi triangle’, which is from northern Japan and far-eastern Russia and bordered by Pakistan and Afghanistan in the west . It is caused by Orientia tsutsugamushi and transmitted to human through the bite of the infected larval form (chigger) of the trombiculid mite. The symptoms of the disease include fever, headache, myalgia, cough and gastrointestinal and neurological symptoms . The presence of the eschar is also helpful to the diagnosis. However, some of the neurological symptoms it causes are similar to cervical spondylosis, especially in elderly patients with cervical spine degeneration. Our goal is to clearly identify the cause and propose relevant treatment strategies. Herein, we present a case of scrub typhus–related deltoid paralysis compared with cervical spondylosis. As far as we know, there are not many such cases.
We are grateful to all of the technicians of EMG, MRI and ultrasonography for their assistance.
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
All procedures performed in this study involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Informed consent was obtained from all individual participants included in the study.
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