Patient's Query
Hello doctor,
I am a 40-year-old female. I was diagnosed with scrub typhus, and my multiple sclerosis is making everything worse! I stopped Ocrevus because of a crazy fever. I have a weird black bite mark, and the rash is spreading. My vision is blurry, and my balance is gone. Is this an MS relapse or a complication of typhus?
Please advise.
Hello,
Welcome to icliniq.com.
I understand your concern.
It sounds like both scrub typhus and multiple sclerosis (MS) are hitting you hard, and stopping Ocrevus (Ocrelizumab) due to fever adds another layer of complexity. Managing scrub typhus in someone with MS is challenging because treatments for both conditions can interact. The black scab (eschar) is a classic sign of scrub typhus, but the spreading rash and worsening neurological symptoms could indicate meningoencephalitis (which can cause severe confusion, blurry vision, dizziness, and balance loss) or sepsis (if the bacteria spread, leading to high fever and multi-organ involvement, including the brain). Both are life-threatening conditions.
Stopping Ocrelizumab, combined with high fever, could also trigger an MS relapse, causing symptoms like blurry vision, severe weakness, balance issues, and numbness or tingling sensations. Based on your symptoms, this is not just an MS flare-up, you need urgent medical attention. Go to the hospital immediately.
To assess your condition, doctors will likely perform blood tests, a lumbar puncture, and an MRI (magnetic resonance imaging) to evaluate infection severity and brain involvement. Since scrub typhus can lead to multi-organ failure, additional tests may be needed to check your lungs, liver, kidneys, and heart (such as a chest X-ray or CT (computed tomography) scan, liver function tests (LFT), kidney function tests (KFT), and an ECG).
Oral Doxycycline or Azithromycin is not enough in your case, you will need IV (intravenous) antibiotics. If this is an MS relapse, steroids may help, but they can worsen infections, so they should only be used with caution in a hospital setting.
I hope this helps you.
Thank you.
Same symptoms don't mean you have the same problem. Consult a doctor now!
Disclaimer: No content published on this website is intended to be a substitute for professional medical diagnosis, advice or treatment by a trained physician. Seek advice from your physician or other qualified healthcare providers with questions you may have regarding your symptoms and medical condition for a complete medical diagnosis. Do not delay or disregard seeking professional medical advice because of something you have read on this website. Read our Editorial Process to know how we create content for health articles and queries.