Expanding Neurological Spectrum of Scrub Typhus: A Single-Center Case Series of Cerebral Venous Sinus Thrombosis, Opsoclonus-Myoclonus Syndrome, and Guillain-Barré Syndrome

Description

Kumar Saurabh reports three patients whose scrub typhus attacked the nervous system in three entirely different ways. All were seen within a short span at one tertiary center in eastern India, in a 2026 case series. Each was confirmed by serology, and each traced to a different mechanism: blood-vessel injury, central immune attack, and peripheral immune attack.

The first patient developed cerebral venous sinus thrombosis with a bleeding venous infarct, a clotting disaster made likelier by severe vitamin B12 deficiency and high homocysteine acting as a second hit. The third developed Guillain-Barré syndrome, an acute flaccid weakness with absent late responses on nerve testing and inflammatory spinal fluid. All three recovered well on prompt doxycycline plus targeted therapy: anticoagulation for the clot, corticosteroids for the eye syndrome, and intravenous immunoglobulin for the paralysis. The author argues endemic-region clinicians must suspect scrub typhus behind almost any acute neurological picture.

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Source: https://europepmc.org/article/MED/PMC13399944