J Pediatr Infect Dis 2019; 14(05): 264-266
DOI: 10.1055/s-0037-1615819
Case Report
Georg Thieme Verlag KG Stuttgart · New York

Acute Disseminated Encephalomyelitis as a Complication of Scrub Typhus in Children

Soumya Roy
1  Department of Paediatrics, KSS Hospital, Kolkata, West Bengal, India
2  Department of Paediatric Medicine, Institute of Child Health, Kolkata, West Bengal, India
,
Subroto Chakrabartty
2  Department of Paediatric Medicine, Institute of Child Health, Kolkata, West Bengal, India
› Author Affiliations
Funding None.
Further Information

Publication History

15 September 2017

27 November 2017

Publication Date:
21 February 2018 (eFirst)

Abstract

Scrub typhus is a re-emerging threat throughout the world. The spectra of clinical pictures and possible complications are both varied and being increasingly reported. Acute disseminated encephalomyelitis (ADEM) is an infrequent demyelinating disorder of the central nervous system that is precipitated by infections and immunizations. There are only two documented cases of ADEM-associated scrub typhus published in the medical literature. We report the first pediatric case wherein a 5-year-old boy presented with high fever, altered sensorium, seizure, quadriparesis, and neck rigidity. He was ultimately diagnosed as a case of scrub typhus with ADEM. After treatment with intravenous doxycycline and methylprednisolone, the fever subsided but residual neurodeficits, such as inability to sit, stand, and talk, as well as bowel bladder dysfunctions persisted. He was subsequently transferred to long-term rehabilitation care.