title: Scrub typhus meningitis in a renal transplant recipient.
abstract: Scrub typhus is a rickettsial infection commonly seen in Asia. The clinical presentation ranges from nonspecific febrile illness to potentially fatal multiorgan involvement such as liver, kidney, or lung. Central nervous system involvement is uncommon. We report a 45-year-old female renal transplant recipient who presented with fever, headache, meningeal signs, graft dysfunction, and eschar. IgM antibodies againstOrientia tsutsugamushiwere positive by enzyme-linked immunosorbent assay. Despite oral doxycycline therapy for 5 days, she did not improve but responded well to intravenous azithromycin. To the best of our knowledge, scrub typhus as a cause of meningitis in a renal transplant recipient has not been reported so far.
authors.affiliation: Department of Nephrology, Madras Medical College and Rajiv Gandhi Government General Hospital, Chennai, Tamil Nadu, India.
authors.forename: J
authors.initials: J
authors.lastname: Dhanapriya
authors.affiliation: Department of Nephrology, Madras Medical College and Rajiv Gandhi Government General Hospital, Chennai, Tamil Nadu, India.
authors.forename: T
authors.initials: T
authors.lastname: Dineshkumar
authors.affiliation: Department of Nephrology, Madras Medical College and Rajiv Gandhi Government General Hospital, Chennai, Tamil Nadu, India.
authors.forename: R
authors.initials: R
authors.lastname: Sakthirajan
authors.affiliation: Department of Nephrology, Madras Medical College and Rajiv Gandhi Government General Hospital, Chennai, Tamil Nadu, India.
authors.forename: S
authors.initials: S
authors.lastname: Murugan
authors.affiliation: Department of Nephrology, Madras Medical College and Rajiv Gandhi Government General Hospital, Chennai, Tamil Nadu, India.
authors.forename: V
authors.initials: V
authors.lastname: Jayaprakash
authors.affiliation: Department of Nephrology, Madras Medical College and Rajiv Gandhi Government General Hospital, Chennai, Tamil Nadu, India.
authors.forename: T
authors.initials: T
authors.lastname: Balasubramaniyan
authors.affiliation: Department of Nephrology, Madras Medical College and Rajiv Gandhi Government General Hospital, Chennai, Tamil Nadu, India.
authors.forename: N
authors.initials: N
authors.lastname: Gopalakrishnan
keywords: Doxycycline; eschar; meningitis; scrub typhus