Longitudinally extensive transverse myelitis associated with scrub typhus: A case report

Rationale: Longitudinally extensive transverse myelitis (LETM) is a rare inflammatory demyelinating disease predominantly associated with autoimmune and inflammatory disorders. Scrub typhus can cause a variety of neurological complications, which may result in poor recovery and long-term disability. This report reveals a rare linkage between LETM and scrub typhus. Patient concerns: A 24-year-old female presented with a history of fever for 10 days associated with progressive quadriparesis. Physical examination revealed bilateral lower limb weakness (grade 0/5) and bilateral upper limb weakness (grade 2/5) with reduced sensation below the T3 dermatome. Diagnosis: Scrub typhus presenting with longitudinally extensive transverse myelitis. Interventions: Steroid pulse therapy with antibiotics supported by early intensive rehabilitation. Outcomes: Complete recovery was achieved. Lessons: This case report highlights the importance of considering scrub typhus as a potential cause of LETM in endemic regions, particularly in patients presenting with febrile illness and neurological symptoms.