{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T19:50:41Z","timestamp":1791834641719,"version":"4.3.4"},"reference-count":13,"publisher":"BMJ","issue":"3","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2023,3,16]]},"published-print":{"date-parts":[[2023,3]]},"abstract":"<jats:p>Scrub typhus is a tropical febrile illness that mainly affects rural populations in tropical and subtropical countries. It can range in severity from a mild febrile illness to multisystem involvement. Systemic dysfunction often appears in the second week of sickness, and hepatic, renal and brain involvement are well documented. Although encephalitis is the most frequent neurological ailment, a wide range of unusual complications involving the central and peripheral nervous systems have been identified\u2014however, concomitant multiaxial involvement of the central and peripheral nervous systems is unique. We report a case of a young man with serologically confirmed scrub typhus presenting with fever, eschar, altered sensorium and progressive quadriplegia with hyporeflexic deep tendon reflexes. MRI revealed changes suggestive of encephalitis, and there was evidence of axonopathy on nerve conduction studies. A diagnosis of scrub typhus encephalitis with concomitant Guillain-Barr\u00e9 syndrome was made. He received doxycycline and intravenous immunoglobulin therapy, in addition to supportive treatment.<\/jats:p>","DOI":"10.1136\/bcr-2022-253350","type":"journal-article","created":{"date-parts":[[2023,3,29]],"date-time":"2023-03-29T13:19:44Z","timestamp":1680095984000},"page":"e253350","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":6,"title":["Neurological manifestations of scrub typhus: encephalitis and Guillain-Barr\u00e9 syndrome (GBS)"],"prefix":"10.1136","volume":"16","author":[{"given":"Tanish","family":"Modi","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, GMCH, Chandigarh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tina","family":"Sood","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, GMCH, Chandigarh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandeep","family":"Moudgil","sequence":"additional","affiliation":[{"name":"Radiodiagnosis, GMCH, Chandigarh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4507-2468","authenticated-orcid":false,"given":"Navneet","family":"Arora","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, PGIMER, Chandigarh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2023,3,29]]},"reference":[{"key":"2025082711294463000_16.3.e253350.1","doi-asserted-by":"publisher","DOI":"10.5492\/wjccm.v4.i3.244"},{"key":"2025082711294463000_16.3.e253350.2","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp-2014-308722"},{"key":"2025082711294463000_16.3.e253350.3","doi-asserted-by":"crossref","DOI":"10.3389\/fmicb.2019.02065","article-title":"Scrub typhus pathogenesis: innate immune response and lung 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typhus","volume":"62","author":"Sawale","year":"2014","journal-title":"Neurol India"},{"key":"2025082711294463000_16.3.e253350.12","doi-asserted-by":"publisher","DOI":"10.1007\/s11845-008-0226-z"},{"key":"2025082711294463000_16.3.e253350.13","doi-asserted-by":"crossref","first-page":"1129","DOI":"10.1007\/s12098-022-04312-y","article-title":"Scrub typhus associated with Guillain-Barr\u00e9 syndrome (GBS)","volume":"89","author":"Raghunathan","year":"2022","journal-title":"Indian J Pediatr"}],"container-title":["BMJ Case 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