Scrub typhus meningitis or meningoencephalitis.

[scrub typhus]

Orientia tsutsugamushi induces vasculitis leading to symptoms of systemic organ invasion including meningitis and meningoencephalitis . We conducted a retrospective case-control study of scrub typhus patients to investigate the clinical and laboratory features of patients with scrub typhus meningitis or meningoencephalitis , and the therapeutic outcomes , and to determine the predictor factors . Cases were 22 patients with scrub typhus meningitis or meningoencephalitis , and controls were 303 patients without meningitis or meningoencephalitis . Multivariate analysis showed that the presence of pneumonitis was associated with the occurrence of scrub typhus meningitis and meningoencephalitis (odds ratio [OR ] 8 .9 ; P < 0 .001 ; confidence interval [CI ] 2 .9 -27 .2 ). Although appropriate antimicrobials such as doxycycline agents were administered at an early stage , meningitis or meningoencephalitis still occurred in some cases . Physicians should be aware that meningitis or meningoencephalitis may develop during appropriate drug therapy such as doxycycline . Close observation and great care are essential for patients with risk factors , particularly pneumonitis .