Maladies neuroinfectieuses

Abstrait

An Interesting Case of Papilledema in Scrub typhus

Shakthi KJS, Awadh K Pandit

Scrub typhus has an increased incidence in the recent past. It is a rickettsiae disease caused by Orientia tsutsugamushi. The systemic manifestations of Scrub typhus mainly involves liver, kidney, spleen and Central nervous system and this is reported mostly from South India. We describe the first case of scrub typhus meningitis with bilateral papilledema. As there is a recent increase in scrub typhus cases being reported worldwide, a concurrent increase in the neurological complication has to be anticipated. The diagnosis in our case was made based on the clinical picture and a positive IgM ELISA for scrub typhus. The patient improved completely with oral doxycycline. We highlight the need for a high degree of clinical suspicion and acquaintance with the various central nervous system manifestations including papilledema to allow early diagnosis and treatment thereby reducing patient morbidity and mortality.