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Acute encephalitis syndrome following scrub typhus infection.
[scrub typhus]
The
aim
was
to
find
the
incidence
of
acute
encephalitis
syndrome
(
AES
)
secondary
to
scrub
infection
and
to
observe
the
clinical
,
biochemical
,
radiological
profile
,
and
outcomes
in
these
patients
.
A
total
of
20
consecutive
patients
of
AES
were
evaluated
for
scrub
infection
using
scrub
typhus
immunoglobulin
M
enzyme
linked
immuno-sorbant
assay
positivity
along
with
the
presence
or
absence
of
an
eschar
.
Clinical
profile
,
routine
laboratory
tests
,
cerebrospinal
fluid
(
CSF
)
analysis
,
and
neuroimaging
were
analyzed
.
Patients
were
treated
with
doxycycline
and
followed-up
.
Among
20
consecutive
patients
with
AES
,
6
(
30
%
)
were
due
to
scrub
infection
.
They
presented
with
acute
onset
fever
,
altered
sensorium
,
seizures
.
Eschar
was
seen
in
50
%
of
patients
.
CSF
done
in
two
of
them
was
similar
to
consistent
with
viral
meningitis
.
Magnetic
resonance
imaging
brain
revealed
cerebral
edema
,
bright
lesions
in
the
putamen
and
the
thalamus
on
T
2
-
weighted
and
fluid-attenuated
inversion
recovery
sequences
.
Renal
involvement
was
seen
in
all
patients
.
All
patients
responded
well
to
oral
doxycycline
.
AES
is
not
an
uncommon
neurological
presentation
following
scrub
typhus
infection
.
It
should
be
suspected
in
all
patients
with
fever
,
altered
sensorium
,
and
renal
involvement
.
Oral
doxycycline
should
be
started
as
early
as
possible
for
better
outcomes
.
Diseases
Validation
Diseases presenting
"fever"
symptom
22q11.2 deletion syndrome
acute rheumatic fever
alexander disease
allergic bronchopulmonary aspergillosis
canavan disease
carcinoma of the gallbladder
child syndrome
congenital toxoplasmosis
cushing syndrome
cystinuria
dracunculiasis
erdheim-chester disease
esophageal adenocarcinoma
esophageal carcinoma
familial mediterranean fever
focal myositis
hodgkin lymphoma, classical
lamellar ichthyosis
legionellosis
locked-in syndrome
malignant atrophic papulosis
neonatal adrenoleukodystrophy
neuralgic amyotrophy
oculocutaneous albinism
papillon-lefèvre syndrome
pyomyositis
pyruvate dehydrogenase deficiency
scrub typhus
severe combined immunodeficiency
sneddon syndrome
systemic capillary leak syndrome
triple a syndrome
typhoid
waldenström macroglobulinemia
wolf-hirschhorn syndrome
This symptom has already been validated