Scrub typhus meningitis/meningoencephalitis in Kumaon Region, Uttarakhand

Abstract

Background: Scrub typhus is becoming an increasing cause of meningitis/meningoencephalitis in endemic areas. Materials and Methods: We conducted a retrospective chart review to describe epidemiological features, clinical characteristics, laboratory profile, and therapeutic outcomes in scrub typhus, considering meningitis/meningoencephalitis as cases and patients without meningoencephalitis as controls. Results: A total of 97 scrub typhus positive cases confirmed by immunoglobulin M enzyme-linked immunosorbent assay and/or polymerase chain reaction were included in the study. By univariant analysis, risk factors such as exposure to a forest, adolescent age and associated oliguria were significantly higher among cases as compared to the control group. Signs and symptoms that were significantly higher among meningitis/meningoencephalitis cases were conjuctival suffusion, pharyngitis, maculopapular rash, pain in the abdomen, splenomegaly, and altered sensorium. Cerebrospinal fluid (CSF) pictures closely resembled aseptic meningitis. All patients had received doxycycline or azithromycin, and the outcome was favorable in the case group. Conclusion: Scrub typhus meningitis/meningoencephalitis was significantly higher in adolescents. Close observation and great care is essential for adolescent patients with associated risk factors. Prompt treatment ensures survival.