Scrub typhus presenting as acute transverse myelitis: A rare case report

Introduction- Scrub typhus is a common zoonotic disease with high case fatality rate. Scrub typhus is also known as tsutsugamushi disease or bush typhus. The common neurological manifestations are meningitis and meningoencephalitis, whereas subdural hemorrhage, cerebro vascular accident, acute transverse myelitis are among rare neurological presentation. Case report-A 38 year-old married female, farmer by occupation, was admitted with complaints of high-grade fever with chills for 10days, nausea/vomiting for 8 days, weakness in bilateral lower limb (right>left) for 3days and numbness in bilateral lower limb for 3 days ,unable to pass urine for 1 day. A diagnosis of acute transverse myelitis secondary to scrub was made and patient was put on injection doxycycline 100 mg IV twice-daily ,injection ceftriaxone 1gm IV bd along with symptomatic treatment with hydration, antipyretics and supportive care. Conclusion- In this case, our clinical diagnosis according to the patient's history and examination was transverse myelitis secondary to scrub typhus , that was not correlated with the MRI ,Physician and Radiologists should be aware of this to avoid exclusion or underestimation of the cord disease, they should correlate with the clinical data as well.