Life-threatening scrub typhus with meningoencephalitis and acute respiratory distress syndrome

Chi Tai Fang, Woei Feng Ferng, Juey Jen Hwang, Chong Jen Yu, Yee Chun Chen, Ming His Wang, Shan Chwen Chang, Wei Chuan Hsieh

Research output: Contribution to journalArticle

14 Scopus citations

Abstract

A 21-year-old man presented with fever, rash, seizure, stiff neck and rapidly progressive bilateral pulmonary infiltrates. Cerebrospinal fluid (CSF) study revealed pleocytosis with predominant polymorphonuclear cells, and hypo-glycorrhachia. Status epilepticus occurred, followed by acute respiratory distress syndrome with respiratory failure. Blood and CSF cultures for bacteria were negative, but an indirect immunofluorescence assay revealed a fourfold rise in antibody to Rickettsia tsutsugamushi in paried serum and a 1:2560 (+) IgM antibody titer. Severe scrub typhus with meningoencephalitis and extensive pneumonitis was diagnosed. The patient survived after intravenous minocycline therapy and intensive care, including aggressive seizure control, supportive mechanical ventilation and avoidance of fluid overloading. He had a nearly complete recovery. Practicing physicians in Taiwan should be aware of this reportable disease and its potentially serious complications if not promptly diagnosed and treated.

Original languageEnglish (US)
Pages (from-to)213-216
Number of pages4
JournalJournal of the Formosan Medical Association
Volume96
Issue number3
StatePublished - Mar 1 1997

Keywords

  • Rickettsia tsutsugamushi
  • acute respiratory distress syndrome
  • meningoencephalitis
  • pneumonitis
  • scrub typhus

ASJC Scopus subject areas

  • Medicine(all)

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    Fang, C. T., Ferng, W. F., Hwang, J. J., Yu, C. J., Chen, Y. C., Wang, M. H., Chang, S. C., & Hsieh, W. C. (1997). Life-threatening scrub typhus with meningoencephalitis and acute respiratory distress syndrome. Journal of the Formosan Medical Association, 96(3), 213-216.