Korean Journal of Infectious Diseases  1999;31(3):243-246

A Case of Tsutsugamushi Disease Complicated by Meningoencephalitis.

Sen LYU 1 ; Eui Chang HWANG ; In Ho KIM ; Sok Kyun HONG ; Hyunjoo PAI ; Geun Ho LEE

Affiliations

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Keywords

Tsutsugamushi disease; Scrub typhus; Meningoencephalitis; Central nervous system

Country

Republic of Korea

Language

Korean

Abstract

Scrub typhus can invade central nervous system. The most common findings of CNS involvement are those of low grade meningitis, however, meningoencephalitis with coma and generalized seizure are also reported to occur in scrub typhus but only rarely. A 47-year old male was admitted to our hospital because of consciousness disturbance. The patient had a fever and rash for seven days before admission. He had been treated for diabetes mellitus for three years. Generalized seizure occurred six times after admission. CSF revealed increase of leukocytes (648/mm3) and protein level, and diffuse slow wave was found on electroencephaolography. The magnetic resonance image of the brain showed dural thickening. We diagnosed his illness as tsutsugamushi disease complicated by meningoencephalitis. After treatment with clarithromycin and an anticonvulsant, he recovered without neurological sequelae. O. tsutsugamushi should be considered as one of the causes of meningoencephalitis in endemic areas.