J Clin Neurol.  2008 Mar;4(1):36-39. 10.3988/jcn.2008.4.1.36.

Polyneuropathy and Cerebral Infarction Complicating Scrub Typhus

• Kim JH
• Lee SA
• Ahn TB
• Yoon SS
• Park KC
• Chang DI
• Chung KC

• KMID: 2287684
• DOI: http://doi.org/10.3988/jcn.2008.4.1.36

Abstract

We describe a 64-year-old man with scrub typhus who presented with both polyneuropathy and cerebral infarction. A eurological examination revealed a confused mental state, stiff neck, hearing impairment, symmetric weakness, sensory loss, and ataxia. Electrophysiologic studies showed demyelinating sensorimotor polyneuropathy and sensorineural hearing loss. Brain magnetic resonance imaging showed multiple infarctions. Brain involvement or polyneuropathy associated with scrub typhus has been rarely reported, and the pathogenic mechanism underlying the multiple neurological complications remains to be elucidated.

Keyword

Scrub typhus; Guillain-Barre syndrome; Cerebral infarction

MeSH Terms

Ataxia
Brain
Cerebral Infarction
Guillain-Barre Syndrome
Hearing Loss
Hearing Loss, Sensorineural
Humans
Infarction
Magnetic Resonance Imaging
Middle Aged
Neck
Polyneuropathies
Scrub Typhus

Figure

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  Figure Brain imaging findings. (A) Computed tomography scan on admission showing unremarkable findings. (B) Magnetic resonance (MR) angiography showing normal intra- and extracranial vessels. (C.E) MR imaging scans obtained 17 days after admission showing abnormally high signal intensities in the right parietooccipital cortex and the right corona radiata on a fluid-attenuated inversion recovery image (C) and a diffusion-weighted image (D), with elevated signals on the apparent-diffusion-coefficient map (E).

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