European Journal of Biomedical and Pharmaceutical Sciences

ACUTE ENCEPHALOPATHY SECONDARY TO SCRUB TYPHUS IN AN ELDERLY FARMER: A CASE REPORT

*Dr. Birkenjit Debbarma, Dr. Zakeena, DNB, Dr. G. Rathnakumar, MD

ABSTRACT

Scrub typhus is an infectious disease and an important cause of acute febrile illness in tropical regions.[1,2] It often represents non-specific clinical symptoms, which makes it difficult to diagnose.[2,7] Although neurological involvement is widely recognised, it may mimic other causes of acute encephalopathy.[7] The case reports a         65 year old male farmer with a history of chronic alcohol use who presented with fever and an acute onset of altered sensorium. Clinical examination indicated an eschar over the right thigh and cutaneous erythematous lesions over the trunk and upper limbs. Laboratory investigations revealed thrombocytopenia, transaminitis, hyponatremia, and elevated inflammatory markers. No acute intracranial pathology was detected by neuroimaging. Scrub typhus infection was confirmed by serological testing. The patient was treated with intravenous doxycycline and supportive management included intravenous fluids, antipyretics and thiamine supplementation. The patient showed significant clinical improvement within 48 hours with fever resolution and normalisation of sensorium. The case highlights the significance of considering scrub typhus in differential diagnosis of acute febrile encephalopathy in endemic areas.[3,5] It is crucial for early diagnosis of eschar and prompt initiation of doxycycline therapy for favorable outcomes.[1,7]

Keywords: Scrub typhus, encephalopathy, eschar, thrombocytopenia, doxycycline.