Acute cerebellar ataxia and peripheral neuropathy due to an atypical infection

Area of Science:

• Neurology
• Infectious Diseases
• Pediatrics

Background:

• Cerebellar dysfunction and polyneuropathy are serious neurological conditions.
• Scrub typhus is a bacterial infection transmitted by mites, prevalent in specific geographic regions.
• Prompt diagnosis and treatment are vital for managing infectious neurological complications.

Observation:

• An 18-year-old male presented with acute cerebellar dysfunction and polyneuropathy following a febrile illness with rash.
• Clinical examination revealed left-sided cerebellar signs and peripheral nerve involvement.
• Laboratory findings included thrombocytopenia and elevated liver enzymes (transaminitis).

Findings:

• Magnetic Resonance Imaging (MRI) of the brain was unremarkable, showing no structural abnormalities.
• The patient received empirical treatment for both leptospirosis and scrub typhus.
• A definitive diagnosis of acute cerebellar ataxia and polyneuropathy secondary to scrub typhus infection was established.

Implications:

• This case highlights scrub typhus as a potential cause of acute neurological syndromes, including cerebellar ataxia and polyneuropathy.
• The findings underscore the importance of considering scrub typhus in the differential diagnosis of febrile illnesses with neurological manifestations, particularly in endemic areas.
• Successful recovery without sequelae emphasizes the efficacy of timely empirical treatment for this potentially devastating infection.