An atypical presentation of scrub typhus

Scrub typhus is caused byOrientia tsutsugamushi, characterised by focal or disseminated vasculitis and perivasculitis which may involve the lungs, heart, liver, spleen and central nervous system.The clinical picture and severity of the symptoms varies widely. The neurological manifestations of scrub typhus are diverse. Meningoencephalitis is classical manifestation of scrub typhus but cerebellitis, cranial nerve palsies, plexopathy, transverse myelitis, neuroleptic malignant syndrome and Guillain-Barre syndrome are other manifestations reported in literature. The availability of literature on the neurological manifestations of scrub typhusis limited to case reports mainly. This article shows a case report of neurological manifestations of scrub typhus.

Prevalence and outcome of hyponatremia in patients admitted with COVID-19

Background: Hyponatremia occurs in up to 30% of patients with pneumonia and is associated with increased morbidity and mortality. The prevalence of hyponatremia associated with coronavirus disease 2019 and the impact on outcome is unknown. We aimed to identify the prevalence, and outcome of patients having hyponatremia admitted with COVID-19. Methods: This was a retrospective observational study conducted among admitted adult patients with confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in Srinivas institute of medical sciences and research centre, Mukka, Surathkal.Results: This difference in hyponatremia was statistically significant with regard to age (p<0.001), respiratory rate (p=0.002), SpO2(p=0.029), total counts (p=0.03), CRP (p=0.005), and d-dimer (p=0.015).Conclusions: In patients with COVID-19, age, hypotension, respiratory rate, SpO2, total counts, CRP, and D-Dimer have significant correlation with hyponatremia. Also, patients with COVID-19 and hyponatremia have higher rates of mechanical ventilation and mortality