Rickettsial meningitis and encephalitis

Arch Intern Med. 1991 Sep;151(9):1753-7.


Nine of 72 patients with scrub typhus and three of 137 with murine typhus presented with meningitis and/or encephalitis syndromes. Focal neurologic signs were rare, and cerebrospinal fluid profiles were similar to those of leptospirosis and viral and tuberculous meningitis. One patient had papilledema, and another had cerebellitis. Other major organ involvement (renal, liver, or lungs) occurred in five patients. One patient died and four spontaneously recovered, while the conditions of the rest responded well to either chloramphenicol or doxycycline. Scrub and murine typhus should be included in the differential diagnoses of aseptic meningitis and encephalitis in patients exposed to endemic areas, especially when accompanied by renal insufficiency and/or jaundice. They are treatable forms of virallike meningoencephalitis.

Publication types

  • Case Reports

MeSH terms

  • Adolescent
  • Adult
  • Chloramphenicol / therapeutic use
  • Diagnosis, Differential
  • Doxycycline / therapeutic use
  • Encephalitis / microbiology*
  • Female
  • Humans
  • Male
  • Meningitis / microbiology*
  • Middle Aged
  • Scrub Typhus / diagnosis
  • Scrub Typhus / drug therapy
  • Scrub Typhus / epidemiology*
  • Thailand / epidemiology
  • Typhus, Endemic Flea-Borne / diagnosis
  • Typhus, Endemic Flea-Borne / drug therapy
  • Typhus, Endemic Flea-Borne / epidemiology*


  • Chloramphenicol
  • Doxycycline