Citation:De Silva, C.M., Fonseka, C.L., Nanayakkara, S.D., Singhapura, S.D.A.L., Palangasinghe, D.R., Hewawithana, J.S., Pathirana, K.D. and Bodinayake, C.K. (2018) ‘Differentiating scrub typhus meningoencephalitis, from tuberculous meningitis: Two case reports and a review’, <i>Galle Medical Journal</i>, 23(1), p. 37-41. Available at: https://doi.org/10.4038/gmj.v23i1.7989.
Date:2018-03-01
Abstract:
Scrub typhus is a zoonotic disease where currently
about one million new cases are identified
annually and one billion people may be at risk of
this disease (1-3). The infection is acquired through
agricultural activities in the rice fields, oil palm,
rubber plantation and during recreational activities
in the woods or mountainous areas which are
common in Southeast Asia (4). Scrub typhus is
underdiagnosed due to its nonspecific clinical
presentation and lack of diagnostic facilities. The
clinical manifestations of the disease range from sub-
clinical disease to fatal organ failure (5) and it is
commonly observed in endemic areas as one of the
causes of fever of unknown origin (6). The
pathognomonic clinical sign of scrub typhus is the
presence of an eschar (60%) (7-9), which may be
hidden and painless as it is often present in areas
like breast folds, groin, external genitalia and gluteal
folds which may go unnoticed in dark-skinned
individuals.
