Objective:
To describe a rare presentation of scrub typhus manifesting as isolated cerebellitis in a patient and highlight the importance of early clinical suspicion and timely management to ensure full recovery.
Background:
Scrub typhus is increasingly recognized as a cause of acute undifferentiated febrile illness in Southeast Asia and India. It can present with mild symptoms or severe, life-threatening complications, including liver dysfunction, acute kidney injury, and myocarditis. Neurological manifestations are varied, but cerebellar involvement is rarely reported. We present a case of isolated cerebellitis due to scrub typhus, a presentation not previously documented.
Results:
The patient exhibited fever and significant cerebellar dysfunction, initially misattributed to other tropical infections. A high index of suspicion led to the diagnosis of scrub typhus confirmed by positive IgM serology. The patient was treated with doxycycline and dexamethasone, resulting in substantial improvement in neurological function by day 14 of hospitalisation. Upon discharge, the patient showed no lasting neurological deficits, and all cerebellar symptoms, including nystagmus and tremors, had resolved by the two-week follow-up.
Conclusions:
This case underscores the critical importance of maintaining clinical vigilance for scrub typhus, especially in cases with atypical neurological presentations like isolated cerebellitis. Timely diagnosis and appropriate treatment with antibiotics and steroids can lead to full recovery, significantly reducing morbidity. This case contributes to the growing body of evidence on the diverse clinical spectrum of scrub typhus and the necessity for heightened awareness among healthcare providers.
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