{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T18:15:42Z","timestamp":1784657742587,"version":"3.55.0"},"reference-count":18,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2024,9,2]],"date-time":"2024-09-02T00:00:00Z","timestamp":1725235200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"National Institutes of Health, Bethesda, MD, USA","award":["NINDS #R01 NS39422"],"award-info":[{"award-number":["NINDS #R01 NS39422"]}]},{"DOI":"10.13039\/501100000780","name":"European Commission","doi-asserted-by":"crossref","award":["ICT-2011-287739"],"award-info":[{"award-number":["ICT-2011-287739"]}],"id":[{"id":"10.13039\/501100000780","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100003329","name":"Ministry of Economy and Competitiveness","doi-asserted-by":"crossref","award":["RTC-2015-3967-1"],"award-info":[{"award-number":["RTC-2015-3967-1"]}],"id":[{"id":"10.13039\/501100003329","id-type":"DOI","asserted-by":"crossref"}]},{"name":"Spanish Health Research Agency","award":["FIS PI12\/01602"],"award-info":[{"award-number":["FIS PI12\/01602"]}]},{"name":"Spanish Health Research Agency","award":["FIS PI16\/00451"],"award-info":[{"award-number":["FIS PI16\/00451"]}]},{"name":"The Recovery, Transformation and Resilience Plan at the Ministry of Science and Innovation","award":["TED2021-130174B-C33"],"award-info":[{"award-number":["TED2021-130174B-C33"]}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["The Neurohospitalist"],"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Scrub typhus is an acute febrile infectious disease highly prevalent in the Asia Pacific region, often referred to as the \u201ctsutsugamushi triangle.\u201d This mite-borne rickettsial zoonosis is caused by Orientia tsutsugamushi, an intracellular Gram-negative organism that primarily targets endothelial cells. The resulting vasculitis leads to multisystem involvement. In terms of neurological manifestations, meningoencephalitis is the most common presentation of scrub typhus. Other frequent neurological manifestations include cranial nerve paresis, transverse myelitis, and polyneuropathy. Status epilepticus, while reported, is a rare presenting feature of this infection. Although scrub typhus has been documented to present as limbic encephalitis, there have been no previous descriptions in the literature of neuroradiological patterns affecting the basal ganglia or extra-limbic cortices in this condition.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case Report<\/jats:title>\n                    <jats:p>We report a case of a 23-year-old previously healthy woman who presented with scrub typhus meningoencephalitis. The condition manifested as encephalitis with involvement of the basal ganglia and extra-limbic cortices. She presented with generalized convulsive status epilepticus, which was complicated by cortical multifocal myoclonus.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>Scrub typhus can be a significant diagnostic challenge, potentially presenting with generalized convulsive status epilepticus and mimicking both clinical and radiological features of arboviral encephalitides, such as those caused by West Nile and Japanese encephalitis viruses. Furthermore, as demonstrated in this case, its radiological presentation can resemble that of autoimmune encephalitis. Given that scrub typhus is amenable to treatment with antibiotics, such as doxycycline and azithromycin, which do not increase seizure risk, it should be considered in the differential diagnosis for patients presenting with seizures or encephalitis, especially in endemic areas.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/19418744241276903","type":"journal-article","created":{"date-parts":[[2024,9,2]],"date-time":"2024-09-02T04:08:05Z","timestamp":1725250085000},"page":"182-187","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":6,"title":["Scrub Typhus Meningoencephalitis Presenting as Generalized Convulsive Status Epilepticus with Basal Ganglia and Extra-limbic Cortical Involvement, Complicated by Cortical Multifocal Myoclonus"],"prefix":"10.1177","volume":"15","author":[{"given":"Uttam","family":"Biswas","sequence":"first","affiliation":[{"name":"Department of General Medicine, Burdwan Medical College and Hospital, Burdwan, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1766-4183","authenticated-orcid":false,"given":"Mois\u00e9s","family":"Le\u00f3n-Ruiz","sequence":"additional","affiliation":[{"name":"Section of Clinical Neurophysiology, Department of Neurology, University Hospital \u201cLa Paz\u201d, Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8192-0807","authenticated-orcid":false,"given":"Ritwik","family":"Ghosh","sequence":"additional","affiliation":[{"name":"Department of General Medicine, Burdwan Medical College and Hospital, Burdwan, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ritun","family":"Sarkar","sequence":"additional","affiliation":[{"name":"Department of General Medicine, Burdwan Medical College and Hospital, Burdwan, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raghul","family":"Bheeman","sequence":"additional","affiliation":[{"name":"Department of General Medicine, Burdwan Medical College and Hospital, Burdwan, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arpan","family":"Mukhopadhyay","sequence":"additional","affiliation":[{"name":"Department of General Medicine, Burdwan Medical College and Hospital, Burdwan, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1769-4809","authenticated-orcid":false,"given":"Juli\u00e1n","family":"Benito-Le\u00f3n","sequence":"additional","affiliation":[{"name":"Department of Neurology, University Hospital \u201c12 de Octubre\u201d, Madrid, Spain"},{"name":"Instituto de Investigaci\u00f3n Sanitaria Hospital 12 de Octubre (i+12), Madrid, Spain"},{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red Sobre Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain"},{"name":"Department of Medicine, Faculty of Medicine, Complutense University, Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2024,9,2]]},"reference":[{"key":"bibr1-19418744241276903","doi-asserted-by":"publisher","DOI":"10.1177\/0049475516636543"},{"key":"bibr2-19418744241276903","doi-asserted-by":"publisher","DOI":"10.1080\/01658107.2021.1909073"},{"key":"bibr3-19418744241276903","doi-asserted-by":"publisher","DOI":"10.1177\/19418744211016107"},{"key":"bibr4-19418744241276903","doi-asserted-by":"publisher","DOI":"10.18103\/mra.v10i10.3196"},{"key":"bibr5-19418744241276903","doi-asserted-by":"publisher","DOI":"10.1007\/s10072-022-06021-y"},{"key":"bibr6-19418744241276903","doi-asserted-by":"publisher","DOI":"10.1016\/j.nrleng.2022.04.005"},{"key":"bibr7-19418744241276903","doi-asserted-by":"publisher","DOI":"10.1016\/j.nrleng.2022.07.001"},{"key":"bibr8-19418744241276903","doi-asserted-by":"publisher","DOI":"10.4103\/aian.AIAN_198_18"},{"key":"bibr9-19418744241276903","doi-asserted-by":"publisher","DOI":"10.1111\/epi.13412"},{"key":"bibr10-19418744241276903","doi-asserted-by":"publisher","DOI":"10.3390\/brainsci12091130"},{"key":"bibr11-19418744241276903","doi-asserted-by":"publisher","DOI":"10.1111\/epi.13121"},{"key":"bibr12-19418744241276903","doi-asserted-by":"publisher","DOI":"10.1177\/1756285610395653"},{"key":"bibr13-19418744241276903","doi-asserted-by":"publisher","DOI":"10.1016\/j.toxicon.2022.02.008"},{"key":"bibr14-19418744241276903","doi-asserted-by":"publisher","DOI":"10.1186\/s41983-021-00374-5"},{"key":"bibr15-19418744241276903","doi-asserted-by":"publisher","DOI":"10.1111\/epi.17241"},{"key":"bibr16-19418744241276903","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(15)00401-9"},{"key":"bibr17-19418744241276903","volume-title":"Arbovirus 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