Table 2.
Clinical, laboratory, and therapeutic findings in scrub typhus patients with meningitis or meningoencephalitis
| Patient/Age/sex | IgM/IgG (at admission) | Associated complications | Headache | Neck stiffness | Mental status | Admission days after onset of symptoms | CSF study | Antibiotics | Mental status recovery time after admission | |||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| IgM/IgG (follow up) | Tapping Days after admission | WBC | Protein | Glucose | ||||||||
| 1/79/M | 160/64 | ARF, Pneumonitis GI bleeding | Yes | No | 3 | 7 | 4 d | 43 (67/33) | 62.3 | 52.9 | D for 5 d R for 9 d | 8 d |
| 2/76/F | 320/4096 320/4096 | Pneumonitis | No | Yes | 3 | 7 | 0 d | 38 (90/10) | 144 | 36.8 | D for 6 d (before admission) R for 10 d | 5 d |
| 3/72/M | 80/256 80/1024 | Pneumonitis ARF CN palsy | No | No | 1 | 5 | 0 d | 205 (90/10) | 170 | 57 | D for 4 d (before admission) R for 11 d | 3 d |
| 4/76/F | 0/512 640/512 | Meningitis, Gastric ulcer, Duodenal ulcer | Yes | No | 2 | 22 | 0 d | 70 (75/25) | 100.9 | 46.1 | D for 4 d (before admission) D for 5 d | 2 d |
| 5/82/F | 0/1024 0/4096 | Pneumonitis GI bleeding | No | No | 2 | 4 | 0 d | 6 | 104 | 62.7 | D for 2 d (before admission), D for 11 d | 10 d |
| 6/55/F | 320/2048 1280/4096 | Duodenal ulcer | Yes | Yes | 3 | 2 | 0 d | 295 (5/95) | 87.7 | 71.2 | D for 2d (before admission) D for 11d | 4 d |
| 7/69/M | 640/2048 640/4096 | Pneumonitis Shock | No | Yes | 2 | 5 | 2 d | 37 (30/70) | 107.9 | 48 | D for 2 d (before admission) D for 14 d, then R for 5 d | 15 d |
| 8/72/F | 0/2048 80/4096 | Yes | No | 1 | 7 | 0 d | 20 (73/27) | 54.2 | 62 | D for 3 d (before admission) D for 7 d | ||
| 9/72/F | 0/2048 0/512 | Pneumonitis, Myocarditis Shock | Yes | Yes | 3 | 10 | 1 d | 79 (70/30) | 97.4 | 39 | D for 2 d (before admission) Doxy for 6 d | 5 d |
| 1076/M | 0/16384 80/8192 | Pneumonitis, ARF Shock | Yes | Yes | 3 | 7 | 1 d | 6 | 23.8 | 57 | D for 3 d (before admission) R for 11 d | 10 d |
| 11/77/F | 80/16384. | Yes | No | 4 | 14 | 4 d | 16 (40/60) | 48.4 | 191 | D for 11 d | 7 d | |
| 12/66/F | 1280/2048. | Pneumonitis | Yes | No | 1 | 3 | 3 d | 38 (63/37) | 107 | 56 | D for 5 d | – |
| 13/76/F | 640/4096 1280/4096 | Pneumonitis | Yes | No | 1 | 5 | 1 d | 8 | 54 | 93 | D for 7 d | – |
| 14/65/F | 0/0 1280/4096 | Yes | No | 1 | 5 | 0 d | 7 | 65.9 | 76.4 | D for 8 d | – | |
| 15/60/F | 80/32 80/2048 | Pneumonitis CN palsy | Yes | . | 1 | 4 | 1 d | 5 | 47 | 47 | D for 5 d | – |
| 16/43/F | 160/1024 1280/8192 | Yes | Yes | 1 | 7 | 2 d | 28 (75/25) | 41.8 | 92 | D for 5 d | – | |
| 17/88/F | 0/1024 0/8192 | Yes | Yes | 2 | 8 | 1 d | 6 | 33.8 | 96.9 | D for 5 d | 1 d | |
| 18/70/M | 320/128 2560/512 | Pneumonitis Deep vein thrombosis | Yes | Yes | 2 | 14 | 13 (70/30) | 60.2 | 47.7 | R for 11 d | 4 d | |
| 19/70/M | 0/512 1280/2048 | Meningitis, Gastric ulcer, Duodenal ulcer | Yes | Yes | 2 | 7 | 126 (46/54) | 132.6 | 140.6 | R for 5 d | 2 d | |
| 20/67/M | 0/32 0/0 | Meningitis | No | No | 2 | 5 | 8 | 68.1 | 42.6 | R for 4 d | 1 d | |
| 21/65/M | 0/32 40/128 | Pneumonitis CN palsy | No | Yes | 3 | 7 | 2 d | 111 (45/55) | 122 | 50 | R for 7 d | 4 d |
| 22/70/F | 40/512 80/512 | Pneumonitis | Yes | Yes | 1 | 10 | 0 d | 10 (20/80) | 35 | 53 | T for 5 d | – |
Mental state: 1. alert, 2. confusion, 3. obtunded, 4. stupor, 5. coma.
R: rifampin, D: doxycycline, T: telithromycin, P: pneumonia
CSF = cerebrospinal fluid; WBC = white blood cell; ARF = acute renal failure; GI bleeding = gastrointestinal bleeding; CN palsy = cranial nerve palsy.