Prolonged coma in scrub typhus: consider non-convulsive status epilepticus

Abstract Background Scrub typhus is prevalent in the Tsutsugamushi belt and may manifest with meningoencephalitis and seizures. We report a patient with scrub typhus who had non-convulsive status epilepticus (NCSE). Methods A 50-y-old female with fever and altered sensorium for 5 d was diagnosed as...

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Published in:Transactions of the Royal Society of Tropical Medicine and Hygiene 2021-09, Vol.115 (9), p.1091-1093
Main Authors: Kalita, Jayantee, Jadhav, Mahesh S, Singh, Varun K, Misra, Usha K
Format: Article
Language:English
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Summary:Abstract Background Scrub typhus is prevalent in the Tsutsugamushi belt and may manifest with meningoencephalitis and seizures. We report a patient with scrub typhus who had non-convulsive status epilepticus (NCSE). Methods A 50-y-old female with fever and altered sensorium for 5 d was diagnosed as scrub typhus based on serum IgM ELISA. She was on mechanical ventilation and received doxycycline and ceftriaxone, but did not improve until the third day of admission. Results An EEG revealed >2.5 Hz generalised epileptiform discharges, which were suppressed by intravenous lorazepam suggesting NCSE. Following valproate and levetiracetam, she became conscious and had a full recovery. Conclusion A scrub typhus patient recovers even after prolonged NCSE.
ISSN:0035-9203
1878-3503
DOI:10.1093/trstmh/trab007