{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T15:10:50Z","timestamp":1777907450875,"version":"3.51.4"},"reference-count":8,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2023,9,6]],"date-time":"2023-09-06T00:00:00Z","timestamp":1693958400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Trop Doct"],"published-print":{"date-parts":[[2024,1]]},"abstract":"<jats:p>Scrub typhus is a re-emerging and endemic disease in the Asia Pacific region caused by Orientia tsutsugamushi. We present a 65-year-old male from Sri Lanka who presented with fever, bilateral acute sensorineural hearing loss, and confusion. On examination, he was dehydrated. Significant orthostatic hypotension and an eschar were noted. Investigations revealed hyponatraemia with elevated urine sodium, reduced serum osmolality, and normal urine osmolality suggestive of cerebral salt wasting. After initial hydration with 0.9% NaCl, hyponatraemia was corrected with 3% NaCl. Oral doxycycline was prescribed, and he showed dramatic clinical improvement. A diagnosis of typhus must be considered in a patient presenting with a febrile illness and acute hearing loss. Cerebral salt-wasting disease should be considered in a patient with typhus who develops hyponatraemia with dehydration. Furthermore, acute sensorineural hearing loss in both ears is an important manifestation of the disease.<\/jats:p>","DOI":"10.1177\/00494755231195933","type":"journal-article","created":{"date-parts":[[2023,9,6]],"date-time":"2023-09-06T04:49:12Z","timestamp":1693975752000},"page":"69-71","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Case report of scrub typhus with bilateral acute sensorineural hearing loss and cerebral salt-wasting disease"],"prefix":"10.1177","volume":"54","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4726-5861","authenticated-orcid":false,"given":"Asitha","family":"Goonetilleke","sequence":"first","affiliation":[{"name":"Registrar, University Medical Unit, Colombo South Teaching Hospital, Kalubowila-Dehiwala, Sri Lanka"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7348-4830","authenticated-orcid":false,"given":"Shehan","family":"Silva","sequence":"additional","affiliation":[{"name":"Registrar, University Medical Unit, Colombo South Teaching Hospital, Kalubowila-Dehiwala, Sri Lanka"},{"name":"Consultant Physician & Senior Lecturer, Department of Medicine, Faculty of Medical Sciences, University of Sri Jayewardenepura, Nugegoda, Sri Lanka"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2023,9,6]]},"reference":[{"key":"bibr1-00494755231195933","doi-asserted-by":"publisher","DOI":"10.4038\/jccp.v48i2.7823"},{"key":"bibr2-00494755231195933","doi-asserted-by":"publisher","DOI":"10.1016\/S1995-7645(12)60036-4"},{"key":"bibr3-00494755231195933","doi-asserted-by":"publisher","DOI":"10.1086\/498747"},{"key":"bibr4-00494755231195933","doi-asserted-by":"publisher","DOI":"10.4038\/cmj.v67i2.9634"},{"key":"bibr5-00494755231195933","doi-asserted-by":"publisher","DOI":"10.4103\/0972-9062.308809"},{"key":"bibr6-00494755231195933","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2334-9-173"},{"key":"bibr7-00494755231195933","doi-asserted-by":"publisher","DOI":"10.1002\/ccr3.4451"},{"key":"bibr8-00494755231195933","volume":"12","author":"Soundararajan S","year":"2020","journal-title":"Cureus"}],"container-title":["Tropical Doctor"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/00494755231195933","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/00494755231195933","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/00494755231195933","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T13:35:44Z","timestamp":1777642544000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/00494755231195933"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,9,6]]},"references-count":8,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2024,1]]}},"alternative-id":["10.1177\/00494755231195933"],"URL":"https:\/\/doi.org\/10.1177\/00494755231195933","relation":{},"ISSN":["0049-4755","1758-1133"],"issn-type":[{"value":"0049-4755","type":"print"},{"value":"1758-1133","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,9,6]]}}}