Volume 96, Issue 3
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645



Central nervous system involvement manifesting as meningitis or meningoencephalitis is a known complication of scrub typhus, but very few spinal cord lesions such as acute transverse myelitis (ATM) have been reported in association with this disease. Scrub typhus patients with a spinal lesion present with neurologic symptoms including dysuria, motor, and sensory weakness. Herein, we describe a rare case of ATM associated with scrub typhus. Clinical characteristics, cerebrospinal fluid cytology, serum antibody titer, and serial magnetic resonance imaging scans resulted in a diagnosis of ATM associated with scrub typhus.


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  1. Jeong YJ, Kim S, Wook YD, Lee JW, Kim KI, Lee SH, , 2007. Scrub typhus: clinical, pathologic, and imaging findings. Radiographics 27: 161172.[Crossref] [Google Scholar]
  2. Kim DM, Kim SW, Choi SH, Yun NR, , 2010. Clinical and laboratory findings associated with severe scrub typhus. BMC Infect Dis 10: 108.[Crossref] [Google Scholar]
  3. Varghese GM, Mathew A, Kumar S, Abraham OC, Trowbridge P, Mathai E, , 2013. Differential diagnosis of scrub typhus meningitis from bacterial meningitis using clinical and laboratory features. Neurol India 61: 1720.[Crossref] [Google Scholar]
  4. Jamil MD, Hussain M, Lyngdoh M, Sharma S, Barman B, Bhattacharya PK, , 2015. Scrub typhus meningoencephalitis, a diagnostic challenge for clinicians: a hospital based study from north-east India. J Neurosci Rural Pract 6: 488493.[Crossref] [Google Scholar]
  5. Kim JH, Lee SA, Ahn TB, Yoon SS, Park KC, Chang DI, Chung KC, , 2008. Polyneuropathy and cerebral infarction complicating scrub typhus. J Clin Neurol 4: 3639.[Crossref] [Google Scholar]
  6. Pai H, Sohn S, Seong Y, Kee S, Chang WH, Choe KW, , 1997. Central nervous system involvement in patients with scrub typhus. Clin Infect Dis 24: 436440.[Crossref] [Google Scholar]
  7. Lee KL, Lee JK, Yim YM, Lim OK, Bae KH, , 2008. Acute transverse myelitis associated with scrub typhus: case report and a review of literatures. Diagn Microbiol Infect Dis 60: 237239.[Crossref] [Google Scholar]
  8. Mahajan SK, Kumar S, Garg M, Kaushik M, Sharma S, Raina R, , 2016. Scrub typhus with longitudinally extensive transverse myelitis. J Vector Borne Dis 53: 8486. [Google Scholar]
  9. Transverse Myelitis Consortium Working Group, 2002. Proposed diagnostic criteria and nosology of acute transverse myelitis. Neurology 59: 499505.[Crossref] [Google Scholar]
  10. Jacob A, Weinshenker BG, , 2008. An approach to the diagnosis of acute transverse myelitis. Semin Neurol 28: 105120.[Crossref] [Google Scholar]
  11. Kerr D, Krishnan C, Pidcock FS, Singer H, Kossoff E, Hartman A, Crawford T, Singer HS, Kossoff EH, Hartman AL, Crawford TO, , 2005. Acute transverse myelitis. , eds. Treatment of Pediatric Neurologic Disorders. Boca Raton, FL: Taylor and Francis Group. [Google Scholar]
  12. Lee CS, Hwang JH, , 2015. Images in clinical medicine. Scrub typhus. N Engl J Med 373: 2455.[Crossref] [Google Scholar]
  13. Drevets DA, Leenen PJ, Greenfield RA, , 2004. Invasion of the central nervous system by intracellular bacteria. Clin Microbiol Rev 17: 323347.[Crossref] [Google Scholar]
  14. Settle EB, Pinkerton H, Corbett AJ, , 1945. A pathologic study of tsutsugamushi disease (scrub typhus) with notes on clinicopathologic correlation. J Lab Clin Med 30: 639661. [Google Scholar]
  15. Levine HD, , 1946. Pathologic study of thirty-one cases of scrub typhus fever with especial reference to the cardiovascular system. Am Heart J 31: 314328.[Crossref] [Google Scholar]
  16. Kim DE, Lee SH, Park KI, Chang KH, Roh JK, , 2000. Scrub typhus encephalomyelitis with prominent focal neurologic signs. Arch Neurol 57: 17701772.[Crossref] [Google Scholar]
  17. Hirono H, Yamadori A, Komiyama M, Yakura H, Yasui T, , 1992. MRI of spontaneous spinal cord infarction: serial changes in gadolinium-DTPA enhancement. Neuroradiology 34: 9597.[Crossref] [Google Scholar]
  18. Friedman DP, Tartaglino LM, Fisher AR, Flanders AE, , 1995. MR imaging in the diagnosis of intramedullary spinal cord diseases that involve specific neural pathways or vascular territories. Am J Roentgenol 165: 515523.[Crossref] [Google Scholar]
  19. Mawad ME, Rivera V, Crawford S, Ramirez A, Breitbach W, , 1990. Spinal cord ischemia after resection of thoracoabdominal aortic aneurysms: MR findings in 24 patients. Am J Roentgenol 155: 13031307.[Crossref] [Google Scholar]
  20. Kincaid O, Lipton HL, , 2006. Viral myelitis: an update. Curr Neurol Neurosci Rep 6: 469474.[Crossref] [Google Scholar]
  21. Hughes RA, Cornblath DR, , 2005. Guillain-Barre syndrome. Lancet 366: 16531666.[Crossref] [Google Scholar]
  22. Willison HJ, Jacobs BC, van Doorn PA, , 2016. Guillain-Barre syndrome. Lancet 388: 717727.[Crossref] [Google Scholar]
  23. Lee SH, Jung SI, Park KH, Choi SM, Park MS, Kim BC, Kim MK, Cho KH, , 2007. Guillain-Barre syndrome associated with scrub typhus. Scand J Infect Dis 39: 826828.[Crossref] [Google Scholar]
  24. Byun WM, Park WK, Park BH, Ahn SH, Hwang MS, Chang JC, , 1998. Guillain-Barre syndrome: MR imaging findings of the spine in eight patients. Radiology 208: 137141.[Crossref] [Google Scholar]
  25. Lee CS, Hwang JH, Lee HB, Kwon KS, , 2009. Risk factors leading to fatal outcome in scrub typhus patients. Am J Trop Med Hyg 81: 484488.[Crossref] [Google Scholar]
  26. Kim DM, Chung JH, Yun NR, Kim SW, Lee JY, Han MA, Lee YB, , 2013. Scrub typhus meningitis or meningoencephalitis. Am J Trop Med Hyg 89: 12061211.[Crossref] [Google Scholar]

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  • Received : 27 Jun 2016
  • Accepted : 04 Dec 2016
  • Published online : 23 Jan 2017

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