A Rare Presentation of Scrub Typhus: Multi-Organ Dysfunction [Acute Kidney Injury, Hepatitis] and Acute Respiratory Distress Syndrome
Bhaumil Shah *
Department of Medicine, Dhiraj Hospital, SBKS MIRC, Vadodara, Gujarat, India.
Sunil Kumar
Department of Medicine, Dhiraj Hospital, SBKS MIRC, Vadodara, Gujarat, India.
Shaily Shah
Department of Medicine, Dhiraj Hospital, SBKS MIRC, Vadodara, Gujarat, India.
*Author to whom correspondence should be addressed.
Abstract
Scrub typhus is an acute febrile illness caused by Orientia tsutsugamushi- a gram negative intracellular bacilli. It typically manifests as eschar formation, fever, rash, myalgia and diffuse lymphadenopathy. The clinical severity of scrub typhus ranges from mild fever to a lethal outcome. Complications like sepsis, acute respiratory distress syndrome (ARDS) and multi organ dysfunction syndrome (MODS)--hepatitis, acute kidney injury contribute to the higher mortality rates, which range from 7-30% in untreated cases. Here, we report a case of 35 years old male who presented with complaints of fever, headache, generalised abdominal pain and dry cough for 7 days. The patient was tested positive for Scrub Typhus IgM antibody; and was complicated with MODS- AKI, Hepatitis and ARDS. After extensive intensive care, monitoring and treatment of 15-20 days, the patient recovered. Hence, early diagnosis and prompt treatment aids in decreasing the mortality in such cases.
Keywords: Orientia tsutsugamushi, scrub typhus, ARDS, MODS