{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T04:20:55Z","timestamp":1772943655693,"version":"3.50.1"},"reference-count":16,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2024,7,27]],"date-time":"2024-07-27T00:00:00Z","timestamp":1722038400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,7,27]],"date-time":"2024-07-27T00:00:00Z","timestamp":1722038400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Med Case Reports"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Scrub typhus, caused by <jats:italic>Orientia tsutsugamushi<\/jats:italic>, rarely leads to central nervous system involvement. Although intracerebral bleeding is rare due to endemicity and a significant proportion of underdiagnoses, it should be considered a noteworthy differential diagnosis in endemic regions in patients with relevant history and clinical findings.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Case presentation<\/jats:title>\n                <jats:p>We present the case of a 40-year-old Nepali woman who visited the emergency department with complaints of left-sided weakness for 6 hours and an acute febrile illness with an eschar for 7 days and was diagnosed with scrub typhus by immunoglobulin M enzyme-linked immunosorbent assay of the serum. Imaging revealed a right-sided frontotemporal hematoma, and further examination revealed pulmonary edema with multiple organ dysfunction syndrome. The patient was mechanically ventilated and was treated with antibiotics, steroids, vasopressors, and antipyretics. However, the hematoma was treated conservatively, with ongoing neurological recovery at the 6-month follow-up.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>Although neurological complications and intracranial hemorrhage are uncommon, physicians must be cautious when making differential diagnoses and initiating appropriate therapies to avoid serious or fatal complications.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s13256-024-04667-0","type":"journal-article","created":{"date-parts":[[2024,7,27]],"date-time":"2024-07-27T00:03:05Z","timestamp":1722038585000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Scrub typhus with hemorrhagic stroke: a case report"],"prefix":"10.1186","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0826-0520","authenticated-orcid":false,"given":"Om Prakash","family":"Bhatta","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sabita","family":"Chand","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hemant","family":"Chand","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Prashant","family":"Bhetwal","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sachin","family":"Awasthi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aruna","family":"Acharya","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ram Chandra","family":"Poudel","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2024,7,27]]},"reference":[{"issue":"7","key":"4667_CR1","doi-asserted-by":"publisher","first-page":"761","DOI":"10.1136\/jnnp-2014-308722","volume":"86","author":"UK Misra","year":"2015","unstructured":"Misra UK, Kalita J, Mani VE. Neurological manifestations of scrub typhus. J Neurol Neurosurg Psychiatry. 2015;86(7):761\u20136.","journal-title":"J Neurol Neurosurg Psychiatry"},{"issue":"1","key":"4667_CR2","doi-asserted-by":"publisher","first-page":"22","DOI":"10.1177\/0049475516636543","volume":"47","author":"A Rana","year":"2017","unstructured":"Rana A, Mahajan SK, Sharma A, Sharma S, Verma BS, Sharma A. Neurological manifestations of scrub typhus in adults. Trop Doct. 2017;47(1):22\u20135.","journal-title":"Trop Doct"},{"issue":"8","key":"4667_CR3","doi-asserted-by":"publisher","first-page":"491","DOI":"10.1007\/s11910-022-01215-5","volume":"22","author":"S Basu","year":"2022","unstructured":"Basu S, Chakravarty A. Neurological manifestations of scrub typhus. Curr Neurol Neurosci Rep. 2022;22(8):491\u20138.","journal-title":"Curr Neurol Neurosci Rep"},{"issue":"2","key":"4667_CR4","doi-asserted-by":"publisher","first-page":"32","DOI":"10.3390\/tropicalmed7020032","volume":"7","author":"AL Matos","year":"2022","unstructured":"Matos AL, Curto P, Sim\u00f5es I. Moonlighting in Rickettsiales: expanding virulence landscape. Trop Med Infect Dis. 2022;7(2):32.","journal-title":"Trop Med Infect Dis"},{"issue":"2","key":"4667_CR5","first-page":"78","volume":"6","author":"A Pokhrel","year":"2021","unstructured":"Pokhrel A, Rayamajhee B, Khadka S, Thapa S, Kapali S, Pun SB, et\u00a0al. Seroprevalence and clinical features of scrub typhus among febrile patients attending a referral hospital in Kathmandu. Nepal Trop Med Infect Dis. 2021;6(2):78.","journal-title":"Nepal Trop Med Infect Dis"},{"issue":"20","key":"4667_CR6","doi-asserted-by":"publisher","first-page":"138","DOI":"10.1186\/s12879-020-4861-y","volume":"13","author":"R Gautam","year":"2020","unstructured":"Gautam R, Parajuli K, Tshokey T, Stenos J, Sherchand JB. Diagnostic evaluation of IgM ELISA and IgM Immunofluorescence assay for the diagnosis of Acute Scrub Typhus in central Nepal. BMC Infect Dis. 2020;13(20):138.","journal-title":"BMC Infect Dis"},{"issue":"11","key":"4667_CR7","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pntd.0010952","volume":"16","author":"AM Alam","year":"2022","unstructured":"Alam AM, Gillespie CS, Goodall J, Damodar T, Turtle L, Vasanthapuram R, et\u00a0al. Neurological manifestations of scrub typhus infection: a systematic review and meta-analysis of clinical features and case fatality. 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The patient agreed to participate in this study. Informed consent was obtained from the patient prior to the study.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Written informed consent was obtained from the patient for publication of this case report and any accompanying images. A copy of the written consent is available for review by the Editor-in-Chief of this journal.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"All authors certify that they have no competing interests to declare that are relevant to the content of this article.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"343"}}