Case Report Acute febrile illness with skin rash with multiorgan affection presented as scrub typhus
Scrub Typhus
DOI:
https://doi.org/10.15713/ins.bhj.184Keywords:
Weil Felix Test, Orientia tsutsugamushi, skin rash with Eschar formationAbstract
Abstract :
Aim: To diagnose and treat the patient with acute febrile illness and multiorgan failure affection who presented as scrub typhus
Background: Scrub typhus fever is a disease caused by Orientia Tsutsugamushi
Case Description: Adult male patient who has gone for picnic at hilly area and who presented after 5 days with acute febrile illness and deteriorated with skin rash and multi organ affection. His tropical fever panel investigations were normal and found to have high titre of Weil Felix test and PCR for rickettsia was positive. He responded well with doxycycline injection and was discharged.
Conclusion: Scrub typhus is characterized by skin rash initially maculopapular, progressing to petechial and spreading centripetally in patient with high fever, myalgia, and headache with supportive epidemiologic or exposure history .Classical triad includes Morbilliform eruption plus fever plus necrotic papule (eschar at the tick bite site) should prompt diagnosis of scrub typhus infection.
Clinical significance: With prompt diagnosis and identifying the main characteristic features of scrub typhus such as Eschar is important to identify so that the appropriate treatment can be started. Doxycycline is the mainstay treatment
References
References:
Warrell Clare E., et. al.: Imported rickettsial infections to the United Kingdom, 2015–2020. Journal of Infection 2023; 86.5: pp. 446-452.
Richards Allen L., Jiang Ju: Scrub typhus: historic perspective and current status of the worldwide presence of Orientia species. Tropical medicine and infectious disease 2020; 5.2: pp. 49.
Zeng B.S., Zeng B.Y., Hung C.M., Kuo H.C., Chen Y.W., Suen M.W., Shiue Y.L., Tseng P.T., Chen CH.: The efficacy and tolerability of antibiotics in scrub typhus: an updated network meta-analysis of randomized controlled trials. Int J Infect Dis 2022 Sep; 122: pp. 461-468.
Downloads
Published
Issue
Section
License
Copyright (c) 2026 Bombay Hospital Journal
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
© The Author(s). 2024 Open Access. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (https://creativecommons. org/licenses/by-nc/4.0/), which permits unrestricted use, distribution, and non-commercial reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/ zero/1.0/) applies to the data made available in this article, unless otherwise stated.
