24/06/2026
Pleased to share that my single-author case series managed at Orchid Hospital Ranchi, has been published in Cureus (Springer Nature), a US-based, PubMed-indexed open-access journal.
Case series-
Expanding the Neurological Spectrum of Scrub Typhus: A Single-Center Case Series of CVT, Opsoclonus-Myoclonus Syndrome, and Guillain-Barré Syndrome (Cureus 18(6): e111396 — DOI: 10.7759/cureus.111396)
Three serologically confirmed scrub typhus patients, encountered within a short window at our centre, each presenting with a rare and mechanistically distinct neurological syndrome:
Case 1 — Cerebral venous sinus thrombosis. A young man with superior sagittal sinus thrombosis and hemorrhagic venous infarction, on a dual-hit prothrombotic background of severe B12 deficiency with marked hyperhomocysteinemia. Anticoagulated despite the intracranial bleed per international guidelines, with full functional recovery.
Case 2 — Opsoclonus-myoclonus syndrome. A woman with meningoencephalitis and seizures in whom opsoclonus and myoclonus emerged as sensorium improved — a syndrome documented in only a handful of scrub typhus patients worldwide. Meaningful recovery on corticosteroids alone, in a resource-constrained setting where IVIG was not feasible.
Case 3 — Guillain-Barré syndrome. An older man with ascending sensorimotor polyradiculoneuropathy and unusually marked CSF lymphocytic pleocytosis, pointing to overlapping inflammatory radiculitis. Brisk response to IVIG.
All three were recognized early and recovered favourably with doxycycline plus condition-specific therapy. To my knowledge, the co-occurrence of cerebrovascular, central immune-mediated, and peripheral immune-mediated phenotypes within one institutional cohort has not previously been reported.
A reminder that in endemic regions, scrub typhus deserves a place in the differential of any unexplained febrile neurological illness.
