{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,13]],"date-time":"2026-03-13T18:12:08Z","timestamp":1773425528083,"version":"3.50.1"},"reference-count":31,"publisher":"Public Library of Science (PLoS)","issue":"3","license":[{"start":{"date-parts":[[2026,3,13]],"date-time":"2026-03-13T00:00:00Z","timestamp":1773360000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Joint Project of Yunnan Science and Technology Department and Kunming Medical University","award":["202101AY070001\u2014217"],"award-info":[{"award-number":["202101AY070001\u2014217"]}]},{"name":"Kunming Health Science and Technology Personnel Training Project","award":["2020 (Province)-21"],"award-info":[{"award-number":["2020 (Province)-21"]}]},{"name":"Yunnan Key Specialty of Pediatric Infection"},{"name":"Key Science and Technology Program of Yunnan Province"}],"content-domain":{"domain":["www.plosntds.org"],"crossmark-restriction":false},"short-container-title":["PLoS Negl Trop Dis"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To investigate the clinical distinctions between scrub typhus meningitis and brucellar meningitis in children, and to identify potential biomarkers with early differential diagnostic value to support clinical decision-making.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective analysis was conducted on 13 pediatric patients diagnosed with brucellar meningitis admitted to Kunming Children\u2019s Hospital over the past decade. Thirteen cases of scrub typhus meningitis were selected as controls using an age- and sex-matching strategy. The clinical manifestations, laboratory findings, and cerebrospinal fluid (CSF) characteristics were compared between the two groups. Receiver operating characteristic (ROC) curve was employed to assess the diagnostic performance and clinical utility of key biomarkers.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The pre-admission fever and duration of fever were significantly shorter in the scrub typhus meningitis group. Laboratory evaluation revealed that serum ferritin, procalcitonin (PCT), C-reactive protein (CRP), and creatinine (Cr) levels were markedly higher in the scrub typhus group compared with the brucellosis group. No statistically significant differences were observed in CSF biochemical parameters. ROC analysis demonstrated that ferritin (AUC\u2009=\u20090.870) and PCT (AUC\u2009=\u20090.846) exhibited the greatest diagnostic accuracy, followed by CRP (AUC\u2009=\u20090.814) and Cr (AUC\u2009=\u20090.799). All patients achieved complete clinical recovery following standardized treatment, with no recurrences or fatalities.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Although scrub typhus meningitis and brucellar meningitis share considerable clinical overlap in children, serum ferritin and PCT levels may represent potential diagnostic signals for early differential diagnosis, warranting validation in larger prospective cohorts. High Ferritin levels or PCT levels may provide preliminary clues toward scrub typhus meningitis. Early recognition and targeted antimicrobial therapy are associated with favorable prognostic outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pntd.0014107","type":"journal-article","created":{"date-parts":[[2026,3,13]],"date-time":"2026-03-13T17:41:31Z","timestamp":1773423691000},"page":"e0014107","update-policy":"https:\/\/doi.org\/10.1371\/journal.pntd.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Differentiating scrub typhus meningitis from brucellar meningitis in children: A single-center retrospective study"],"prefix":"10.1371","volume":"20","author":[{"given":"Yonghan","family":"Luo","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yan","family":"Guo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ying","family":"Zhu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Haifeng","family":"Jin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Penghao","family":"Cui","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ruonan","family":"Li","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qingping","family":"Tang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yin","family":"Li","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-8216-6533","authenticated-orcid":true,"given":"Yanchun","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2026,3,13]]},"reference":[{"key":"pntd.0014107.ref001","doi-asserted-by":"crossref","first-page":"392","DOI":"10.1016\/j.vetmic.2009.06.021","article-title":"Brucellosis: a re-emerging zoonosis","volume":"140","author":"MN Seleem","year":"2010","journal-title":"Vet Microbiol"},{"key":"pntd.0014107.ref002","doi-asserted-by":"crossref","first-page":"1541277","DOI":"10.3389\/fmicb.2025.1541277","article-title":"Epidemiological, clinical, and laboratory characteristics of 581 human brucellosis cases in Xinjiang, China","volume":"16","author":"B Luo","year":"2025","journal-title":"Front Microbiol"},{"issue":"2","key":"pntd.0014107.ref003","doi-asserted-by":"crossref","first-page":"184","DOI":"10.3201\/eid2302.151710","article-title":"Changing Epidemiology of Human Brucellosis, China, 1955-2014","volume":"23","author":"S Lai","year":"2017","journal-title":"Emerg Infect Dis"},{"issue":"10","key":"pntd.0014107.ref004","article-title":"Neglected brucellosis in pediatric populations from non-endemic regions: Clinical manifestations and prediction of severe disease in Yunnan Province, China","volume":"19","author":"X Ma","year":"2025","journal-title":"PLoS Negl Trop Dis"},{"issue":"11","key":"pntd.0014107.ref005","article-title":"A review of the global epidemiology of scrub typhus","volume":"11","author":"G Xu","year":"2017","journal-title":"PLoS Negl Trop Dis"},{"key":"pntd.0014107.ref006","doi-asserted-by":"crossref","first-page":"115387","DOI":"10.1016\/j.intimp.2025.115387","article-title":"Emerging threat of scrub typhus: A call for greater awareness and research","volume":"164","author":"V Bhuvaneshwari","year":"2025","journal-title":"Int Immunopharmacol"},{"issue":"5","key":"pntd.0014107.ref007","article-title":"Development and validation of a simple-to-use nomogram for predicting severe scrub typhus in children","volume":"19","author":"Y Luo","year":"2025","journal-title":"PLoS Negl Trop Dis"},{"issue":"4","key":"pntd.0014107.ref008","doi-asserted-by":"crossref","first-page":"887","DOI":"10.1007\/s10096-025-05050-7","article-title":"Eschar is not the sole clue for scrub typhus: a retrospective analysis of pediatric scrub typhus without eschars","volume":"44","author":"Y Luo","year":"2025","journal-title":"Eur J Clin Microbiol Infect Dis"},{"key":"pntd.0014107.ref009","doi-asserted-by":"crossref","first-page":"1700233","DOI":"10.3389\/fcimb.2025.1700233","article-title":"Machine learning-based prediction model for chronic brucellosis: a multi-feature approach using clinical and laboratory data","volume":"15","author":"R Wang","year":"2025","journal-title":"Front Cell Infect Microbiol"},{"key":"pntd.0014107.ref010","doi-asserted-by":"crossref","first-page":"1136674","DOI":"10.3389\/fcimb.2023.1136674","article-title":"Research progress on complications of brucellosis","volume":"13","author":"M Jin","year":"2023","journal-title":"Front Cell Infect Microbiol"},{"key":"pntd.0014107.ref011","doi-asserted-by":"crossref","first-page":"116683","DOI":"10.1016\/j.jns.2020.116683","article-title":"Neurobrucellosis: A neglected entity? 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