What are the investigations to be done and probable diagnosis ?

58yr Female with denovo T2DM presented with non rhythmic, involuntary movements of right lower limb since 2 days which was insidious onset and gradually progressive. She also had past history of fever with myalgias 5 days ago. Sleep- disturbed, Unable to stand or sit. Clinical finding revealed an eschar in lower quadrant of right breast. What are the Investigations to be done and probable diagnosis?

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Chreoathetosis Rt leg . Suggest MRI brain to exclude structural lesion left basal ganglionic area

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1. Choreoathetosis - rule out rheumatic carditis in past , mri brain for any structural lesion 2. Atypical Neurological manifestation of scrub typhus . Send IgM scrub typhus

Scrub typhus with brain involvement

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