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Rickettsial meningitis and encephalitis.

K Silpapojakul¹, C Ukkachoke, S Krisanapan

¹Department of Medicine, Faculty of Medicine, Prince of Songkla University, Thailand.

Archives of Internal Medicine

|September 1, 1991

Summary

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Scrub typhus and murine typhus can cause meningitis and encephalitis, mimicking viral infections. Early diagnosis and treatment with antibiotics like doxycycline are crucial for recovery.

Area of Science:

Infectious Diseases
Neurology
Internal Medicine

Background:

Scrub typhus and murine typhus are important causes of febrile illness in endemic areas.
Neurological complications of typhus are not well-characterized.
Differentiating typhus from other causes of meningoencephalitis is clinically significant.

Observation:

Nine of 72 scrub typhus patients and 3 of 137 murine typhus patients presented with meningitis/encephalitis.
Neurologic signs were infrequent; CSF profiles resembled other infectious meningitis types.
Associated organ involvement (renal, liver, lung) occurred in 5 patients.

Findings:

One patient expired, four recovered spontaneously, and others responded to chloramphenicol or doxycycline.
Scrub and murine typhus are treatable causes of viral-like meningoencephalitis.

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Cerebellitis and papilledema were noted in individual cases.

Implications:

Typhus should be considered in the differential diagnosis of aseptic meningitis/encephalitis in endemic areas.
Co-occurring renal insufficiency or jaundice may suggest typhus.
Prompt antibiotic treatment can lead to favorable outcomes in typhus-induced neurological syndromes.