{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,28]],"date-time":"2026-02-28T05:18:04Z","timestamp":1772255884620,"version":"3.50.1"},"reference-count":22,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2013,12,4]]},"abstract":"<jats:p>\n                    <jats:italic>Orientia tsutsugamushi<\/jats:italic>\n                    induces vasculitis leading to symptoms of systemic organ invasion including meningitis and meningoencephalitis. We conducted a retrospective case-control study of scrub typhus patients to investigate the clinical and laboratory features of patients with scrub typhus meningitis or meningoencephalitis, and the therapeutic outcomes, and to determine the predictor factors. Cases were 22 patients with scrub typhus meningitis or meningoencephalitis, and controls were 303 patients without meningitis or meningoencephalitis. Multivariate analysis showed that the presence of pneumonitis was associated with the occurrence of scrub typhus meningitis and meningoencephalitis (odds ratio [OR] 8.9;\n                    <jats:italic>P<\/jats:italic>\n                    &lt; 0.001; confidence interval [CI] 2.9\u201327.2). Although appropriate antimicrobials such as doxycycline agents were administered at an early stage, meningitis or meningoencephalitis still occurred in some cases. Physicians should be aware that meningitis or meningoencephalitis may develop during appropriate drug therapy such as doxycycline. Close observation and great care are essential for patients with risk factors, particularly pneumonitis.\n                  <\/jats:p>","DOI":"10.4269\/ajtmh.13-0224","type":"journal-article","created":{"date-parts":[[2013,10,28]],"date-time":"2013-10-28T20:15:45Z","timestamp":1382991345000},"page":"1206-1211","source":"Crossref","is-referenced-by-count":37,"title":["Scrub Typhus Meningitis or Meningoencephalitis"],"prefix":"10.4269","volume":"89","author":[{"given":"Dong-Min","family":"Kim","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jong-Hoon","family":"Chung","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Na-Ra","family":"Yun","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Seok Won","family":"Kim","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jun-Young","family":"Lee","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mi Ah","family":"Han","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yong-Bok","family":"Lee","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2795","reference":[{"key":"R1","series-title":"Endoscopy","first-page":"950","article-title":"The clinical significance of upper gastrointestinal endoscopy in gastrointestinal vasculitis related to scrub typhus","volume":"32","author":"Kim","year":"2000"},{"key":"R2","series-title":"Am J Trop Med Hyg","first-page":"162","article-title":"Scrub typhus in Japan: epidemiology and clinical features of cases reported in 1998","volume":"67","author":"Ogawa","year":"2002"},{"key":"R3","series-title":"Southeast Asian J Trop Med Public Health","first-page":"780","article-title":"Septic shock secondary to scrub typhus: characteristics and complications","volume":"33","author":"Thap","year":"2002"},{"key":"R4","series-title":"Ann Intern Med","first-page":"784","article-title":"Scrub typhus: a follow-up study","volume":"55","author":"Elsom","year":"1961"},{"key":"R5","series-title":"Arch Intern Med","first-page":"1753","article-title":"Rickettsial meningitis and encephalitis","volume":"151","author":"Silpapojakul","year":"1991"},{"key":"R6","series-title":"Am J Trop Med Hyg","first-page":"542","article-title":"Usefulness of nested PCR for the diagnosis of scrub typhus in clinical practice: a prospective study","volume":"75","author":"Kim","year":"2006"},{"key":"R7","series-title":"BMC Infect Dis","first-page":"108","article-title":"Clinical and laboratory findings associated with severe scrub typhus","volume":"10","author":"Kim","year":"2010"},{"key":"R8","series-title":"Am J Trop Med Hyg","first-page":"873","article-title":"A comparative study of hepatitis caused by scrub typhus and viral hepatitis A in South Korea","volume":"85","author":"Lee","year":"2011"},{"key":"R9","series-title":"WHO Recommended Surveillance Standards","author":"World Health Organization (WHO)","year":"2004"},{"key":"R10","series-title":"Lancet","first-page":"820","article-title":"Urban epidemic of severe leptospirosis in Brazil. Salvador Leptospirosis Study Group","volume":"354","author":"Ko","year":"1999"},{"key":"R11","series-title":"Crit Care Med","first-page":"1777","article-title":"Screening tests of disseminated intravascular coagulation: guidelines for rapid and specific laboratory diagnosis","volume":"28","author":"Yu","year":"2000"},{"key":"R12","series-title":"Clin Infect Dis","first-page":"436","article-title":"Central nervous system involvement in patients with scrub typhus","volume":"24","author":"Pai","year":"1997"},{"key":"R13","series-title":"Clin Microbiol Infect","first-page":"826","article-title":"Aseptic meningitis as a delayed neurologic complication of murine typhus","volume":"8","author":"Vallejo-Maroto","year":"2002"},{"key":"R14","series-title":"Antimicrob Agents Chemother","first-page":"1078","article-title":"Penetration of doxycycline into cerebrospinal fluid in patients treated for suspected Lyme neuroborreliosis","volume":"33","author":"Dotevall","year":"1989"},{"key":"R15","series-title":"Antimicrob Agents Chemother","first-page":"2457","article-title":"Antimicrobial therapy of rickettsial diseases","volume":"35","author":"Raoult","year":"1991"},{"key":"R16","series-title":"Antimicrob Agents Chemother","first-page":"347","article-title":"Penetration of oral doxycycline into the cerebrospinal fluid of patients with latent or neurosyphilis","volume":"28","author":"Yim","year":"1985"},{"key":"R17","series-title":"Antimicrob Agents Chemother","first-page":"2406","article-title":"In vitro effectiveness of azithromycin against doxycycline-resistant and - susceptible strains of Rickettsia tsutsugamushi, etiologic agent of scrub typhus","volume":"39","author":"Strickman","year":"1995"},{"key":"R18","series-title":"Antimicrob Agents Chemother","first-page":"2626","article-title":"Rifampin concentrations in various compartments of the human brain: a novel method for determining drug levels in the cerebral extracellular space","volume":"42","author":"Mindermann","year":"1998"},{"key":"R19","series-title":"J Antimicrob Chemother","first-page":"719","article-title":"Penetration of rifampicin into the cerebrospinal fluid of adults with uninflamed meninges","volume":"29","author":"Nau","year":"1992"},{"key":"R20","series-title":"PLoS Negl Trop Dis","first-page":"e1789","article-title":"Phenotypic characterization of peripheral T cells and their dynamics in scrub typhus patients","volume":"6","author":"Cho","year":"2012"},{"key":"R21","series-title":"J Infect","first-page":"56","article-title":"Scrub typhus among hospitalized patients with febrile illness in South India: magnitude and clinical predictors","volume":"52","author":"Varghese","year":"2006"},{"key":"R22","series-title":"J Korean Med Sci","first-page":"668","article-title":"Clinical role of interstitial pneumonia in patients with scrub typhus: a possible marker of disease severity","volume":"19","author":"Song","year":"2004"}],"container-title":["The American Society of Tropical Medicine and Hygiene"],"original-title":[],"link":[{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/89\/6\/article-p1206.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.ajtmh.org\/downloadpdf\/journals\/tpmd\/89\/6\/article-p1206.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/www.ajtmh.org\/downloadpdf\/journals\/tpmd\/89\/6\/article-p1206.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,8,7]],"date-time":"2024-08-07T14:14:17Z","timestamp":1723040057000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/89\/6\/article-p1206.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2013,12,4]]},"references-count":22,"journal-issue":{"issue":"6"},"URL":"https:\/\/doi.org\/10.4269\/ajtmh.13-0224","relation":{"has-review":[{"id-type":"doi","id":"10.3410\/f.718157206.793495500","asserted-by":"object"}]},"ISSN":["0002-9637","1476-1645"],"issn-type":[{"value":"0002-9637","type":"print"},{"value":"1476-1645","type":"electronic"}],"subject":[],"published":{"date-parts":[[2013,12,4]]}}}