Sensorineural Hearing Loss: A Rare Manifestation of Scrub Typhus | Chapter 3 | Achievements and Challenges of Medicine and Medical Science Vol. 2

Scrub typhus, caused by Orientia tsutsugamushi, is a re-emerging infectious disease prevalent in countries like China, India, Indonesia, Japan, Korea, the Philippines, Sri Lanka, Taiwan, and Thailand and is an often underestimated public health problem in the Asia Pacific area. The "tsutsugamushi triangle" refers to a geographical region in the Asia-Pacific area where scrub typhus is highly endemic. This triangle spans from northern Japan and far-eastern Russia in the north, to northern Australia in the south, and to Pakistan and Afghanistan in the west. As an underestimated disease, there is still a substantial lack of knowledge about scrub typhus, reflected by the limited epidemiological data and insufficient public health information in its endemic regions. Without appropriate treatment, scrub typhus can lead to severe multiorgan failure, with a case fatality rate of up to 70%.  While fever and systemic complications are common in scrub typhus, neurological manifestations, such as sudden bilateral sensorineural hearing loss (SNHL), are rare but increasingly recognized.

A case of 64-year-old female presented who experienced fever, myalgia, and bilateral sensorineural hearing loss (SNHL), eventually diagnosed as scrub typhus. The diagnostic process was challenging due to the wide clinical spectrum and nonspecific symptoms of the disease. Proposed mechanisms for hearing loss include direct invasion of the central nervous system or vasculitis involving the cochlear nerve. Increased awareness among healthcare providers is essential for prompt diagnosis and treatment. In endemic areas, empirical treatment with doxycycline is advised for suspected cases. This case highlights the need to consider scrub typhus in patients with acute febrile illness and ear-related symptoms, which can lead to early intervention and better patient outcomes.

 

Author (s) Details

Athulya Asokan
Department of General Medicine, Government Medical College, Kottayam, India.

 

Athira V R
Department of General Medicine, Pushpagiri Institute of Medical Sciences, India.

 

Sanal K Thomas
Department of Neurology, Jubilee Mission Medical College, India.

 

Ajeesh Koshy
Department of General Medicine, Pushpagiri Institute of Medical Sciences, India.

 

Please see the book here:- https://doi.org/10.9734/bpi/acmms/v2/2931

Neurological Complications in Tsutsugamushi Disease (Scrub Typhus) from Northeastern Region of India | Chapter 7 | Current Overview on Disease and Health Research Vol. 5

 The thing of this study was to characterize neurological complications in mite typhus from northeastern region of India.

We conducted a prospective study of mite meningoencephalitis at North Eastern Indira Gandhi Regional Institute of Medical lores among cases admitted to sanitarium between October 2009 and November 2011. The clinical filmland of mite typhus are generally associated with fever, rash, myalgia, and verbose lymphadenopathy. The opinion was made grounded on the clinical filmland, presence of an eschar, and a positive Weil – Felix test( WFT) with a titer of> 1160 and if needed a positive mite IgM enzyme linked immunosorbent assay. Lumbar perforation was carried out on cases with headache, nuchal severity, altered sensorium, or cranial whim-whams poverties, and glamorous resonance imaging( MRI) brain was performed if necessary.

The study included 23 cases with mite typhus meningitis who were serologically verified. There were 13 men and 10 women. Fever ≥ 1 week was the most common incarnation(39.1). Unexpectedly, none of them had an eschar. Median cerebrospinal fluid( CSF) cell count, lymphocyte chance, CSF protein, CSF glucose/ blood glucose, CSF ADA were 17 cells/ μL, 90, 86 mg/ dL,0.6605 and3.6 U/ mL, independently. Doxycycline was administered to all cases. In our study, there was no death.

mite typhus can not be ruled out in the absence of Eschar. Because clinical features and CSF findings can be incorrect for tuberculous meningitis, misdiagnosis may affect in gratuitous long- term empirical antituberculous remedy in cases of lymphocytic meningoencephalitis. Detainments in treatment have the eventuality to be fatal. In resource-poor countries, WFT remains a useful and affordable individual tool for this complaint.

Author(s) Details:

S. R. Sharma,
Department of Neurology, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Shillong, Meghalaya, India.

H. Masaraf,
Department of Neurology, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Shillong, Meghalaya, India.

K. G. Lynrah,
Department of Neurology, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Shillong, Meghalaya, India.

M. Lyngdoh,
Department of Neurology, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Shillong, Meghalaya, India.

Please see the link here: https://stm.bookpi.org/CODHR-V5/article/view/8444