Dement Neurocogn Disord.  2017 Sep;16(3):83-86. 10.12779/dnd.2017.16.3.83.

A Case of Scrub Typhus Related Encephalopathy Presenting as Rapidly Progressive Dementia

• Park JH
• Jang JW
• Lee SH
• Oh WS
• Kim SS

• KMID: 2442821
• DOI: http://doi.org/10.12779/dnd.2017.16.3.83

Abstract

BACKGROUND
An infection known to be a major cause of mild encephalitis/encephalopathy with a reversible splenial lesion (MERS). Rapidly progressive dementia is a neurological condition in which dementia progresses in a short period of time.
CASE REPORT
We report on a 78-year-old woman presenting with a rapid decline in cognitive function resulting from a scrub typhus infection. Diffusion weighted images showed a signal intensity at the splenium, and subcortical white matter of both hemispheres suggesting MERS. On the neuropsychological test, the patient showed frontal executive dysfunction.
CONCLUSIONS
This case suggests that diagnosticians should consider the possibility that a MERS patient with a rapidly cognitive decline could have a scrub typhus infection because early diagnosis of scrub typhus is very important in this aspect of the treatment.

Keyword

splenial lesion; dementia; scrub typhus

MeSH Terms

Aged
Brain Diseases*
Cognition
Dementia*
Diffusion
Early Diagnosis
Female
Humans
Neuropsychological Tests
Scrub Typhus*
White Matter

Figure

• 

  Fig. 1 Initial DWI scan showed high signal intensity at splenium (white arrow) and subcortical white matter of both hemispheres (A, B, D, and E). In follow-up DWI performed after 2 months later, the abnormal signal intensity in splenium and subcortical white matter was improved, but a slight abnormality remained (C and F). DWI: diffusion weighted image.

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