Use of High-dose Steroid in a Case of Scrub Typhus with Acutely Progressive Local Neurologic Symptoms.
- Author:
Hyun Cheul CHOI
1
;
Seong Heon WIE
;
So Yeon LEE
;
Sang Il KIM
;
Soung Kyeung PARK
;
Youn Ju JUNG
;
So Lyung JUNG
;
Jeong Su JUN
;
Moon Won KANG
Author Information
1. Department of Internal Medicine, School of Medicine, The Catholic University of Korea, Seoul, Korea. wiesh@chollian.net
- Publication Type:Case Report
- Keywords:
Scrub typhus;
Central nervous systems;
High-dose steroid
- MeSH:
Ampicillin;
Aphasia;
Brain;
Central Nervous System;
Diagnosis;
Doxycycline;
Female;
Humans;
Middle Aged;
Neurologic Manifestations*;
Orientia tsutsugamushi;
Paralysis;
Psychomotor Agitation;
Scrub Typhus*;
Upper Extremity;
Vasculitis
- From:Korean Journal of Infectious Diseases
2002;34(6):391-395
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Scrub typhus, which is caused by Orientia tsutsugamushi, is systemic illness that causes generalized vasculitis. The central nervous system (CNS) is the most crucial target in scrub typhus as in other rickettsial disease. A 54-year-old woman, who was receiving doxycycline under the diagnosis of scrub typhus, developed rapidly progressive neurologic symptoms. During the treatment, abnormal mental function, abnormal lateral gaze, paralysis in upper extremities and dysphasia occurred in the patient. To investigate CNS involvement in the patients, CSF profile (cell count and levels of protein and glucose) and brain radiologic image (brain CT, brain MRI) were concurrently examined. And ampicillin and high-dose steroid were empirically added to her treatment with doxycycline. With use of high-dose steroid, the initial neurologic symptoms such as restlessness and irritability and other disorders like abnormal lateral gaze and paralysis in upper extremities were recovered. And also any other neurologic sequelae did not appear. We could observe the clinical improvements of abnormal neurologic symptoms and signs after use of high-dose steroid in the Orientia tsutsugamushi infected patients. A further intensive study about the steroid therapy in Orientia tsutusgamushi infected patients with focal neurologic symptoms is required.
