Key result
Doxycycline and methylprednisolone rapidly improve acute cerebellitis in a patient with scrub typhus.
Why the study?
While neurological manifestations of scrub typhus are increasingly recognized, cerebellar involvement remains exceedingly rare.
Acute cerebellitis is a rare but important complication of scrub typhus that responds well to doxycycline and methylprednisolone.
Supports considering cerebellitis in scrub typhus differentials; hypothesis-generating and requires confirmation in larger studies.
Scrub typhus, caused by Orientia tsutsugamushi , is an emerging zoonotic infection that typically presents as an acute febrile illness. While neurological manifestations are increasingly recognized, cerebellar involvement remains exceedingly rare. We report the case of a 42-year-old man from Uttar Pradesh who presented with high-grade fever, followed by slurred speech and gait ataxia. Clinical examination revealed cerebellar signs, including dysmetria and dysdiadochokinesia. Laboratory testing confirmed scrub typhus via a positive immunoglobulin M enzyme-linked immunosorbent assay, and other infectious and autoimmune etiologies were excluded. Magnetic resonance imaging of the brain and cerebrospinal fluid analysis were normal. The patient was treated successfully with intravenous doxycycline and methylprednisolone, resulting in rapid clinical improvement. This case highlights acute cerebellitis as an atypical but important complication of scrub typhus, underscoring the need for heightened clinical suspicion in endemic areas.
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Sc et al. (2026) studied this question. A 42-year-old man with scrub typhus developed acute cerebellitis, which improved rapidly after treatment with doxycycline and methylprednisolone.
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