ArticleAnnals of medical and health sciences research
Tsutsugamushi Disease (Scrub Typhus) Meningoencephalitis in North Eastern India: A Prospective Study.
Article in Annals of medical and health sciences research. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 1 of them a synthesis that pooled it.
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Who cites it
15 citing papers in PubMed, 1 synthesis or guideline pooled it, 30 citations in OpenAlex.
- Neurological manifestations of scrub typhus infection: A systematic review and meta-analysis of clinical features and case fatality.PLoS neglected tropical diseases · 2022Pooled it
- Scrub Typhus Meningoencephalitis With Concurrent Brucellosis in Rural Nepal: Diagnostic Challenges With Negative PCR in a Low-Resource Setting.Clinical case reports · 2026Article
- Frequency and distribution of eschar in patients with scrub typhus in India: systematic review of literature and meta-analysis.Le infezioni in medicina · 2024Review
- Prevalence of and factors associated with scrub typhus exposure among the hill tribe population living in high incidence areas in Thailand: a cross-sectional study.BMC public health · 2023Article
- Epidemiology of scrub typhus and other rickettsial infections (2018-22) in the hyper-endemic setting of Mizoram, North-East India.PLoS neglected tropical diseases · 2023Article
- Profile of Scrub Typhus Meningitis/Meningoencephalitis in Children with and without Scrub Typhus IgM Antibody in CSF.Journal of neurosciences in rural practice · 2021Article
- Scrub typhus with multi-organ dysfunction syndrome and immune thrombocytopenia: a case report and review of the literature.Journal of medical case reports · 2019Review
- Emergence of Orientia tsutsugamushi as an important cause of Acute Encephalitis Syndrome in India.PLoS neglected tropical diseases · 2018Article
- Comparison of Scrub Typhus With and Without Meningitis.Indian journal of pediatrics · 2017Article
- Seroprevalence of rickettsial infections and Q fever in Bhutan.PLoS neglected tropical diseases · 2017Article
- Type 1-skewed neuroinflammation and vascular damage associated with Orientia tsutsugamushi infection in mice.PLoS neglected tropical diseases · 2017Article
- Aetiology of acute meningoencephalitis in Cambodian children, 2010-2013.Emerging microbes & infections · 2017Article
- Scrub typhus in hilly regions of north east India.The Indian journal of medical research · 2016Article
- Neurological Facets of Scrub Typhus: A Comprehensive Narrative Review.Annals of Indian Academy of NeurologyArticle
- Bilateral optic disc edema with subconjunctival hemorrhage: Attributed to scrub typhus?Oman journal of ophthalmologyArticle
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Authors and funding
4 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundScrub typhus is rampant in northern, eastern, and southern India. Central nervous system involvement in the form of meningitis or meningoencephalitis is common in scrub typhus. As specific laboratory methods remain inadequate or inaccessible in developing countries, prompt diagnosis is often difficult.
aimThe aim of this study was to characterize neurological complications in scrub typhus from northeastern region of India. SUBJECTS AND
methodsWe did a prospective study of scrub meningoencephalitis at North Eastern Indira Gandhi Regional Institute of Medical Sciences among patients admitted to hospital between October 2009 and November 2011. The diagnosis was made based on the clinical pictures, presence of an eschar, and a positive Weil-Felix test (WFT) with a titer of >1:160 and if required a positive scrub IgM enzyme-linked immunosorbent assay. Lumbar puncture was performed in patients with headache, nuchal rigidity, altered sensorium or cranial nerve deficits, and magnetic resonance imaging (MRI) brain performed if needed.
resultsTwenty-three patients of scrub typhus meningitis that were serologically confirmed were included in the study. There were 13 males and 10 females. Fever ≥1 week was the most common manifestation (39.1%). Interestingly, none had an eschar. Median cerebrospinal fluid (CSF) cell count, lymphocyte percentage, CSF protein, CSF glucose/blood glucose, CSF ADA were 17 cells/μL, 90%, 86 mg/dL, 0.6605 and 3.6 U/mL, respectively. All patients were treated with doxycycline. There was no mortality in our study.
conclusionsAbsence of Eschar does not rule out scrub typhus. Clinical features and CSF findings can mimic tuberculous meningitis so misdiagnosis may lead to unwarranted prolonged empirical antituberculous therapy in cases of lymphocytic meningoencephalitis. Delay in treatment can be potentially fatal. WFT still serves as a useful and affordable diagnostic tool for this disease in resource-poor countries.
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