Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2021 Apr 28;14(4):e241401.
doi: 10.1136/bcr-2020-241401.

Scrub typhus with cerebral venous sinus thrombosis: a rare presentation

Sayonee Das  1 , Sidhartha Chattopadhyay  2 , Kausik Munsi  1 , Sagar Basu  3
Affiliations
Case Reports

Scrub typhus with cerebral venous sinus thrombosis: a rare presentation

Sayonee Das et al. BMJ Case Rep. .

Abstract

This is a rare presentation of scrub typhus with cerebral venous thrombosis. A 32-year-old woman presented with signs of raised intracranial tension. Examination revealed maculopapular skin rashes and an 'eschar' over the right thigh. Nuchal rigidity and bilateral papilloedema were found. Scrub typhus was diagnosed by the presence of IgM antibody in serum. CT scan of the brain showed cerebral oedema. MRI of the brain was normal. Magnetic resonance venography of the brain showed thrombosis of several venous sinuses. Cerebrospinal fluid analysis revealed lymphocytic pleocytosis with raised protein level. Other causes of prothrombotic states were ruled out by doing specific test results. There was no history of hormonal contraception and prolonged bed rest. A case of scrub typhus complicated with meningoencephalitis and cerebral venous thrombosis was diagnosed. She responded to treatment with doxycycline, anticoagulants, antipyrectics and intravenous saline. Early identification of such atypical neurological involvement in scrub typhus was helpful in satisfactory outcome.

Keywords: infection (neurology); infections; infectious diseases; neurology (drugs and medicines).

PubMed Disclaimer

Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Eschar over the medial aspect of the right thigh.
Figure 2
Figure 2
CT of the brain plain showing diffuse cerebral oedema.
Figure 3
Figure 3
Magnetic resonance venography in volume rendering view showing thrombosis (red arrow) in the terminal part of the superior sagittal sinus.
Figure 4
Figure 4
Magnetic resonance venography in volume rendering view showing thrombosis (red arrow) in the straight sinus.
Figure 5
Figure 5
Magnetic resonance venography in volume rendering view showing thrombosis (red arrow) in the right sigmoid and transverse sinus.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Brown GW. Scrub typhus: pathogenesis and clinical syndromes. : Walker DH, . Biology of rickettsial diseases. Vol1. Broca Raton: Florida, CRC Press, 1988: 93–100.
    1. Mathai E, Rolain JM, VERGHESE GM, et al. . Outbreak of scrub typhus in southern India during the cooler months. Ann N Y Acad Sci 2003;990:359–64. 10.1111/j.1749-6632.2003.tb07391.x - DOI - PubMed
    1. Prakash JAJ, Abraham OC, Mathai E. Evaluation of tests for serological diagnosis of scrub typhus. Trop Doct 2006;36:212–3. 10.1258/004947506778604715 - DOI - PubMed
    1. Mishra UK, Kalita J, Mani VE. Neurological manifestations of scrub typhus. JNNP 2015;86:761–6. - PubMed
    1. Rana A, Mahajan SK, Sharma A, et al. . Neurological manifestations of scrub typhus in adults. Trop Doct 2017;47:22–5. 10.1177/0049475516636543 - DOI - PubMed

Publication types