title: Scrub typhus associated with transient parkinsonism and myoclonus.
abstract: Parkinsonism with myoclonus is rarely associated with infectious disease in adults. We present a 55-year-old man experiencing acute onset bilateral limb tremor, rigidity, and myoclonus with small-stepped gait, and skin rash involving the trunk and limbs, after a fever. Serum was positive for anti-Orientia tsutsugamushi immunoglobulin M antibody. Brain MRI revealed no abnormalities. The fever improved with oral doxycycline, and the parkinsonism and myoclonus improved with amantadine and clonazepam. This is a rare case of parkinsonism with myolonus associated with scrub typhus infection.
authors.affiliation: Neurology Section, Department of Internal Medicine, Far Eastern Memorial Hospital, 21 Nan-Ya S. Road, Sec. 2, Pan-Chiao, New Taipei 220, Taiwan. hippus.chiou@msa.hinet.net
authors.forename: Yih-Hwa
authors.initials: YH
authors.lastname: Chiou
authors.forename: Chia-Jui
authors.initials: CJ
authors.lastname: Yang
authors.forename: Tzu-Hsien
authors.initials: TH
authors.lastname: Lai
mesh_terms: D000906:Antibodies / Q000097:blood; D001921:Brain / Q000382:microbiology / Q000473:pathology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009207:Myoclonus / Q000150:complications / Q000209:etiology* / Q000382:microbiology; D012285:Orientia tsutsugamushi / Q000276:immunology / Q000472:pathogenicity; D020734:Parkinsonian Disorders / Q000150:complications / Q000209:etiology* / Q000382:microbiology; D012612:Scrub Typhus / Q000097:blood / Q000150:complications*
chemical_list: D000906:Antibodies