case_images: PMC4374194_01
case_images: 18-year-old adult female who presented to the emergency department in an unconscious state with fever and rash was diagnosed with scrub typhus. The photograph of the patient shows presence of eschar on the right side of the pubic region (red arrows).
case_images: JCIS-5-11-g002.jpg
case_images: PMC4374194_01_JCIS-5-11-g002.jpg
case_images: F1
case_images: On examination, the patient was unconscious, febrile, had maculopapular rash throughout her body, and an eschar was noted on the right side of the pubic region [Figure 1].
case_images: 18-year-old adult female who presented to the emergency department in an unconscious state with fever and rash was diagnosed with scrub typhus. (a and b) SWI images of MRI brain show multiple petechial hemorrages in the splenium and body of corpus callosum (white arrows in 2a) and in the subcortical white matter (white arrows in 2b). (c) Post-contrast MP RAGE axial image shows enhancement of pachymeninges along the frontal lobe bilaterally (white arrows).
case_images: JCIS-5-11-g003.jpg
case_images: PMC4374194_01_JCIS-5-11-g003.jpg
case_images: F2
case_images: Scan revealed micro-hemorrhages in the body and splenium of corpus callosum, as well as in the sub-cortical white matter in bilateral centrum semiovale region [Figure 2a and b]. RAGE) sequence, there was enhancement of the pachymeninges along bilateral frontotemporoparietal lobes [Figure 2c]. Rest of the brain parenchyma was normal.
case_images: 18-year-old adult female who presented to the emergency department in an unconscious state with fever and rash was diagnosed with scrub typhus. The routine MRI sequences (a) T1, (b) T2, and (c) FLAIR show no abnormal signal intensity in the brain parenchyma.
case_images: JCIS-5-11-g004.jpg
case_images: PMC4374194_01_JCIS-5-11-g004.jpg
case_images: F3
case_images: T2 and fluid-attenuated inversion recovery (FLAIR) sequences [Figure 3]. Time of flight (TOF) MRI angiography revealed normal vessels of circle of Willis.