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Dancing eyes and dancing feet in scrub typhus
Neeraja Koti1, Aswani S Mareddy2, Shivashankara K Nagri1
1Department of Internal Medicine, Kasturba Medical College, Manipal University, Manipal, India.
The Australasian Medical Journal
|January 14, 2016
Summary
A young man with fever and breathlessness developed neurological symptoms including myoclonic jerks. Scrub typhus was diagnosed and treated successfully with doxycycline, resolving the neurological signs.
Area of Science:
- Neurology
- Infectious Diseases
Background:
- Scrub typhus, a zoonotic disease caused by Orientia tsutsugamushi, can present with diverse neurological manifestations.
- Early diagnosis and treatment are crucial to prevent severe complications.
Observation:
- A 26-year-old male presented with fever and dyspnea, later developing opsoclonus myoclonus, characterized by involuntary jerky movements and rapid eye movements.
- Brain MRI and CSF analysis excluded structural lesions and meningoencephalitis, respectively.
Findings:
- Diagnostic tests revealed a strongly positive Weil Felix test and elevated IgM antibodies for scrub typhus (OX K titre 1:640).
- The patient received a one-week course of doxycycline.
- Complete resolution of opsoclonus myoclonus was observed post-treatment.
Implications:
- This case highlights scrub typhus as a treatable cause of opsoclonus myoclonus.
- Prompt recognition and management of scrub typhus can lead to favorable neurological recovery.
- Further research into the neuroinvasive potential of scrub typhus is warranted.
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