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Japanese spotted fever with post-infectious encephalitis

Takafumi Wada1, Hitoshi Mori1, Kouji Kida2

  • 1Department of Neurology, Kurashiki Central Hospital, Japan, 1-1-1 Miwa, Kurashiki, Okayama, 710-8602 Japan.

Idcases
|December 23, 2022
PubMed

Insights

Japanese spotted fever (JSF), a rickettsial disease, can cause post-infectious encephalitis. Early treatment is recommended for patients with central nervous system involvement, as seen in this rare case.

Area of Science:

  • Infectious Diseases
  • Neurology
  • Microbiology

Background:

  • Japanese spotted fever (JSF) is a rickettsial illness caused by *Rickettsia japonica*.
  • Central nervous system (CNS) involvement in JSF is rare, with only five previous cases reported.
  • This study details a unique case of JSF with significant neurological manifestations.

Observation:

  • A 74-year-old male presented with fever, rash, and subsequent mental disturbances.
  • Diagnosis of JSF was confirmed via polymerase chain reaction (PCR).
  • Neurological symptoms included altered mental state and abnormal behavior.

Findings:

  • Cerebrospinal fluid analysis, electroencephalography, and SPECT imaging indicated post-infectious encephalitis.
  • The patient's neurological symptoms improved after treatment with intravenous immunoglobulin.
  • This case highlights the potential for *Rickettsia japonica* to induce post-infectious CNS complications.

Implications:

  • JSF should be considered in the differential diagnosis of febrile illnesses with rash and neurological symptoms.
  • Prompt diagnosis and treatment of JSF are crucial to prevent or mitigate neurological sequelae.
  • Further research is warranted to understand the pathogenesis of CNS involvement in JSF.
Keywords:
EncephalitisJapanese spotted fever

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